Strategic Director, Provider Enrollment & Compliance

Boston Children’s Hospital; Westwood (MA); Hybrid; USD 150,000 - 190,000; Full time

Job summary

Boston Children’s Hospital seeks a visionary Director of Provider Enrollment to steer strategic and operational enrollment across the enterprise, including government and out-of-state Medicaid. You will lead a multidisciplinary team, set priorities, and use analytics to drive performance and efficiency in enrollment functions.

Reporting to the Senior Director, Professional Medical Staff Services, you will partner with Revenue Cycle, Government Relations, Payer Relations, and Medical Staff

Qualifications

• Bachelor's degree required; Master's degree in Healthcare Administration or related field preferred.
• Minimum of 8 years of related experience, including 5 years of progressive management experience.
• Strong working knowledge of provider enrollment principles, processes, and applicable regulatory requirements.
• Demonstrated experience leading provider enrollment operations within a complex healthcare organization or multi-entity environment.
• Strong project management and organizational skills, with the ability to manage multiple priorities and enterprise-wide initiatives simultaneously.
• Demonstrated ability to use data and analytics to identify opportunities, solve complex problems, and drive process improvement.
• Strong leadership, communication, relationship-building, and influencing skills, with the ability to effectively engage senior leaders and diverse stakeholders.
• Demonstrated ability to navigate ambiguity, exercise sound judgment, set priorities, and make timely decisions.
• Ability to manage complex relationships with composure, interpersonal savvy, and strong listening skills.
• Certified Provider Enrollment Specialist (CPES) preferred.

Responsibilities

• Provides strategic direction and operational oversight for provider and facility enrollment across the enterprise.
• Oversees contracted payer, government, and out-of-state Medicaid enrollment activities, ensuring timely, accurate, and compliant submissions.
• Leads and develops the Provider Enrollment team, including managers and staff; establishes priorities, delegates effectively, develops talent, and fosters accountability and continuous improvement.
• Uses data, analytics, and performance metrics to identify opportunities, evaluate outcomes, and drive process improvements across provider enrollment functions.
• Leads strategic and tactical projects with enterprise-wide impact, managing multiple initiatives, timelines, resources, and stakeholder needs.
• Partners with PO Billing, Patient Financial Services, Government Relations, Payer Relations, Medical Staff Services, and other clinical and administrative leaders to improve enrollment processes and outcomes.
• Identifies opportunities to leverage technology and develop efficient, scalable models for provider enrollment across multiple entities.
• Develops, maintains, and implements policies, procedures, and governance related to provider enrollment.
• Oversees the Provider Enrollment budget and collaborates with leadership on staffing, resources, and strategic priorities.
• Collaborates with the Sr. Director, Medical Staff Services, to identify opportunities for process integration and improvement across related functions.
• Serves as a strategic partner to senior leaders, using sound judgment, analytical expertise, and cross-functional influence to address complex issues and support decision-making.

Skills

Leadership

Project management

Data analytics

Communication

Stakeholder management

Education

Bachelor's degree

Master's degree in Healthcare Administration or related field

Job description

Boston Children’s Hospital seeks a visionary Director of Provider Enrollment to steer strategic and operational enrollment across the enterprise, including government and out-of-state Medicaid. You will lead a multidisciplinary team, set priorities, and use analytics to drive performance and efficiency in enrollment functions.

Reporting to the Senior Director, Professional Medical Staff Services, you will partner with Revenue Cycle, Government Relations, Payer Relations, and Medical Staff