Strategic Manager, Provider Enrollment & Payer Ops

Valley Health System; Blacksburg (VA); On-site; USD 101,000 - 127,000; Full time

Benefits offered by this job

Medical/dental/vision benefits

Retirement plan

Tuition assistance

Employee Assistance Program (EAP)

Paid time off & holidays

Job summary

Valley Health System is seeking a Manager of Provider Enrollment and Managed Care Operations to oversee payer relations, provider enrollment, and delegated credentialing. You will translate the organization’s managed care strategy into new operational processes and supervise a team to ensure accurate, timely enrollment and credentialing while maintaining compliance.

The role acts as a liaison across Revenue Cycle, Legal, Finance and clinical leadership, driving payer strategy adoption and

Qualifications

• Bachelor’s Degree required.
• 5+ years’ experience in managed care in a health care setting (medical office/hospital/insurance) required.
• 3+ years’ experience in payer enrollment with experience with delegated credentialing strongly preferred.
• Knowledge of the healthcare industry and payor reimbursement methodologies.

Responsibilities

• Oversee payer relations, provider enrollment and delegated credentialing operations.
• Direct leadership to the provider enrollment team ensuring timely, accurate enrollment and records maintenance.
• Serve as internal owner for delegated credentialing and ensure regulatory compliance.
• Coordinate input from Revenue Cycle, Payer Analytics, Legal, Finance, and clinical leadership to implement payer strategies and policies.

Skills

Leadership

Payer operations

Provider enrollment

Credentialing knowledge

Reimbursement knowledge

Strategic planning

Process optimization

Analytics

Contract interpretation

Regulatory compliance

Stakeholder management

Communication skills

Data analysis

Change management

Relationship management

Education

Bachelor’s Degree

Job description

Valley Health System is seeking a Manager of Provider Enrollment and Managed Care Operations to oversee payer relations, provider enrollment, and delegated credentialing. You will translate the organization’s managed care strategy into new operational processes and supervise a team to ensure accurate, timely enrollment and credentialing while maintaining compliance.

The role acts as a liaison across Revenue Cycle, Legal, Finance and clinical leadership, driving payer strategy adoption and