Supervisor, Provider Enrollment

Beth Israel Lahey Health; Wakefield (MA); On-site; USD 68,000 - 130,000; Full time

Job summary

Beth Israel Lahey Health seeks a Supervisor of Provider Enrollment to lead the enrollment team and coordinate with payors to ensure accurate, timely enrollment transactions and revenue capture.

The role requires 3–5 years in provider enrollment/credentialing, strong Medicare/Medicaid knowledge, and advanced Microsoft Office skills, with leadership responsibilities including staff supervision and cross-functional projects.

Qualifications

• High School diploma or GED required; Bachelor's degree preferred.
• 3-5 years related work experience required and 0-1 years supervisory/management experience.
• 3-5 years related work experience in physician group practice management, provider enrollment relations, contract management or credentialing.
• Knowledge of Medicare, Medicaid and behavioral health provider enrollment.
• Advanced skills with Microsoft applications (Outlook, Word, Excel, PowerPoint or Access) and other web-based applications.

Responsibilities

• Provide daily ongoing supervision and feedback to the enrollment team; supervise, update, and oversee policy and procedures of enrollment function.
• Maintain delegated credentialing agreements and coordinate audits with PSA on health plans.
• Track performance metrics and implement quality initiatives to enrollment operations; ensure enrollment with payors is completed within required time frames.
• Ensure compliance with enrollment criteria in payor contracts and understand provider information needed for risk contracting.
• Oversee quarterly reconciliation of provider lists and binding authority documentation; manage participating provider agreements and amendments.
• Manage relationships with payors to resolve operational issues between providers and payors affecting enrollment or revenue capture.
• Assist cross-functional projects relating to provider and hospital data; represent enrollment to committees.
• Develop educational programs for participating providers in response to new legislative directives (HIPAA, Medicare Reform Act, NPI).

Skills

Provider enrollment

Policy development

Team leadership

Microsoft Office

Education

Bachelor's degree

High School diploma or GED

Tools

Microsoft Office

Job description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Reporting to the Director, Provider Enrollment and Network Relations, the Supervisors of Provider Enrollment are responsible for the processing and coordination of all provider enrollment transactions. Assures the enrollment team delivers quality services in accordance to BILPN's mission and with all applicable policies, procedures, and professional standards. The Supervisors will monitor both internal and external relationship with health plans, providers and escalated inquiries, and deploy suggested improvements in policy and enrollment processes and the systems that support them to ensure compliance with internal and external standards and to improve efficiency. The Supervisors will also be responsible for initial and ongoing training and educational opportunities for enrollment staff, and continued maintenance of training materials. Operates as the main lead on internal cross-functional teams within BILPN.

Job Description

Primary Responsibilities

• Provide daily ongoing supervision and feedback to the BILPN enrollment team. Supervise, maintains, updates, and oversees policy and procedures of the enrollment function, including enrollment procedures with payors and internal partners. (essential)
• Maintains, and tracks delegated credentialing agreements. Coordination with PSA on delegation audits for health plans. Manages required contractual notifications to payors pertaining to specific providers and applies stringent confidentiality standards with regard to same. (essential)
• Assists the director on tracking performance metrics, and implements quality initiatives to enrollment operations; ensures enrollment with payors is completed within required time frames to ensure optimal revenue capture. (essential)
• Assures BILPN compliance with regards to enrollment criteria in payor contracts; responsible for understanding the provider information needed for risk contracting. (essential)
• Oversees quarterly reconciliation of provider lists and binding authority documentation to ensure adequate enrollment procedures for payors. Assists on the distribution, collection, and tracking of participating provider agreements and any related amendments. (essential)
• Assists the director on managing the relationships with payors to identify and resolve operational issues between providers and payors that affect enrollment, practice operations, or revenue capture. Ensures health plan enrollment occurs in a timely manner. (essential)
• Identifies and resolves payor or enrollment related issues that impact the BILPN network. And build strong customer relationship-both internal and external and deliver solutions that meet customer expectations. (essential)
• Assist, as needed, the coordination of cross-functional projects relating to provider and hospital data; represents BILPN to various internal and external committees. (essential)
• Assists the director on developing educational programs for participating providers in response to new legislative directives, e.g. HIPAA, Medicare Reform Act, NPI. Assists Develops new administrative processes within BILPN and in concert with practices to ensure that providers comply with these new enrollment requirements. (essential)

• Has the authority to direct and support employees daily work activities. Has the direct responsibility to undertake the following employment actions: hiring, termination, corrective action and performance reviews.

Required Qualifications

• High School diploma or GED required. Bachelor's degree preferred.
• 3-5 years related work experience required and 0-1 years

Supervisory/management Experience Required

• 3-5 years related work experience in physician group practice management, provider enrollment relations, contract management or credentialing.
• Knowledge of Medicare, Medicaid and behavioral health provider enrollment.
• Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web based applications. May produce complex documents, perform analysis and maintain databases.

Pay Range

$67,995.00 USD - $130,000.00 USD

The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.

More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.

Equal Opportunity Employer/Veterans/Disabled