Provider Enrollment Operations Lead

County of Ventura; Ventura (CA); On-site; USD 90,000 - 110,000; Full time

Job summary

County of Ventura is seeking a Provider Enrollment Manager to oversee third party payor enrollments across the Health Care Agency. The role emphasizes leadership, collaboration with credentialing teams, and process improvement in a fast-paced public health setting.

The ideal candidate will combine administrative expertise with experience in provider enrollment and contract interpretation, ensuring accurate roster communications and compliant documentation.

Qualifications

• Strong communication, interpersonal, and administrative skills.
• Experience with third party payor enrollments and interpreting practitioner and payor contracts.
• Intermediate skills with Microsoft Word and Excel.

Responsibilities

• Manages/oversees provider enrollment operations with private and government payors.
• Oversees the efficiency and accuracy of provider enrollment vendor activities and billing processes.
• Oversees the monthly health plan rosters and timely communication of roster changes.
• Manages and maintains database provider enrollment records in MDStaff.
• Collaborates with the Hospital Medical Staff credentialing team for timely payor enrollments.
• Monitors and investigates payor denials related to enrollments and roster discrepancies.
• Develops/manages department enrollment policies & procedures.
• Manages distribution and attestation process of health plan specific orientation/training requirements.
• Maintains documents related to enrollments and provider enrollment applications.
• Manages annual provider certificates of insurance with the malpractice carrier.
• Drafts database enrollment related reports to support the enrollment process.
• Creates accounts related to Practitioner Cerner HNAuser and Bedrock.
• Supervise and trains administrative support staff.
• Performs other related duties as required.

Skills

Effective communication

Interpersonal skills

Administrative skills

Microsoft Word

Microsoft Excel

Provider enrollment knowledge

Tools

MDStaff

PAVE (Medi-Cal)

PECOS (Medicare)

Job description

County of Ventura is seeking a Provider Enrollment Manager to oversee third party payor enrollments across the Health Care Agency. The role emphasizes leadership, collaboration with credentialing teams, and process improvement in a fast-paced public health setting.

The ideal candidate will combine administrative expertise with experience in provider enrollment and contract interpretation, ensuring accurate roster communications and compliant documentation.