Strategic Director, Claims & Enrollment Operations

denverhealth; Denver (CO); Sur place; USD 180 000 - 240 000; Plein temps

Résumé du poste

Denver Health is seeking a Director of Claims & Enrollment to lead the daily operations of claims, enrollment, and credentialing while providing strategic oversight of encounters and system configuration. The role focuses on compliance, operational integrity, and driving efficiency across multiple teams and vendor partners.

The position requires leadership to maintain accurate operations, improve processing outcomes, and drive continuous improvement in a complex regulatory environment.

Responsabilités

• Oversee daily operations of claims, enrollment, and credentialing in line with CMS, CO Medicaid, CO Division of Insurance requirements.
• Direct weekly/monthly encounters submissions, drive improvements to rejection rates and submission outcomes through vendor oversight.
• Balance operational continuity with ongoing improvements and problem solving across claims, enrollment, credentialing, encounters, and system configuration.

Description du poste

Denver Health is seeking a Director of Claims & Enrollment to lead the daily operations of claims, enrollment, and credentialing while providing strategic oversight of encounters and system configuration. The role focuses on compliance, operational integrity, and driving efficiency across multiple teams and vendor partners.

The position requires leadership to maintain accurate operations, improve processing outcomes, and drive continuous improvement in a complex regulatory environment.