Senior Provider Enrollment & Managed Care Specialist

St Jude Children's Research Hospital; Memphis (TN); Hybrid; USD 40,000 - 69,000; Full time

Job summary

St. Jude Children's Research Hospital in Memphis, TN seeks a Senior Managed Care Specialist (Provider Enrollment) to manage provider enrollment and credentialing tasks for hospital-employed or contracted physicians within insurance programs.

The role focuses on efficient, cost-effective healthcare delivery, working with internal/external teams, and maintaining high-quality standards. Onsite presence is required at least two days per week.

Qualifications

• High school diploma/GED required.
• 4+ years of experience in a healthcare, academic or research setting.
• Experience with EPIC and CREDENTIALSTREAM preferred.

Responsibilities

• Independently execute and manage managed care tasks within own area of responsibility (e.g., provider enrollment and credentialing, claims, payor issues).
• Work closely with internal and external teams (e.g., clients, customers) to coordinate, clarify information, and resolve issues.
• Support payer communications efforts (e.g., new publications, guidelines) and other supportive documentation.
• Manage denial issues related to contractual, enrollment or credentialing issues in a timely manner; monitor own delivery for compliance with overall guidelines, policies & procedures.
• Perform other duties as assigned to meet the goals and objectives of the department and institution.
• Maintains regular and predictable attendance.

Skills

Managed care experience

Enrollment coordination

Communication skills

Education

High school diploma/GED

Tools

EPIC

CredentialStream

Job description

St. Jude Children's Research Hospital in Memphis, TN seeks a Senior Managed Care Specialist (Provider Enrollment) to manage provider enrollment and credentialing tasks for hospital-employed or contracted physicians within insurance programs.

The role focuses on efficient, cost-effective healthcare delivery, working with internal/external teams, and maintaining high-quality standards. Onsite presence is required at least two days per week.