Provider Enrollment Manager

This position is incentive eligible.

Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Provider Enrollment Manager today with Parallon.


Job Summary and Qualifications

The Provider Enrollment Manager is responsible for providing supervision and structure for the department's daily operations and functions. The Manager works to ensure department productivity and quality standards are met or exceeded by coordinating staffing and developing efficient workflows. The Manager guides the staff in their day-to-day responsibilities, including mentoring and training the staff as needed. Proficient in facilitation and interpersonal communication, the Manager also consistently demonstrates skills in organization, prioritization, professionalism and coaching others.

What you will do in this role:

• Coordinate and communicate continuously with other departments to share information, best practices, systems issues, process solutions, and training needs
• Oversee the Provider Enrollment process including document processing, application/notification submission with Commercial and Government payors, and credentialing activities, in coordination with Managed Care, Credentialing Processing Centers (CPCs) and Provider Enrollment Account Managers
• Attend acquisition, initial, and recurring enrollment status calls with practices as needed to ensure seamless transition and implementation
• Coordinate with Provider Enrollment Account Manager and Managed Care on payor issues identified and collaboratively works with the payor until resolution
• Communicate credentialing and enrollment updates to enrollment contacts and senior leadership as needed
• Respond to provider enrollment customer service inquiries
• Ensure compliance with company and departmental policies and procedures
• Proactively review and provide data analysis and financial impact assessments
• Establish and review internal controls to ensure goals, objectives, standards, and benchmarks for the department are met or exceeded
• Assist in timely month-end closing activities
• Determine staff hours, number of personnel, and resources required for efficiency
• Screen, interview, and hire new employees
• Evaluate staff and Team Lead performance and recommend appropriate merit increases and promotions
• Counsel staff and Team Leads regarding disciplinary and performance issues
• Mentor staff and Team Leads for career development
• Ensure training needs are met
• Conduct regular staff meetings
• Maintain working knowledge of all regulatory bodies that impact policies and procedures, such as National Committee for Quality Assurance (NCQA), Medicare, and state Medicaid guidelines
• Understand payor enrollment reporting requirements for delegated credentialing, demographic changes, and adverse actions, as well as how to review Federal Code of Regulations (FCR) for Medicare requirements
• Coordinate with staff on appeal opportunities
• Actively participate in payor audits as needed
• Maintain working knowledge of workflow, systems, and tools used in the department
• Promote continuous improvement and best practice in processes and performance for improving department functions
• Lead in the creation and maintenance of a positive working environment
• Review employee engagement results and facilitate the development of action plans

Qualifications:

• Bachelor's Degree in Business or related field required. Equivalent work experience may substitute education requirements.
• Minimum three years' experience in related area preferred with two of these years being healthcare management experience.

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources , including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits


Note: Eligibility for benefits may vary by location.

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Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

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"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Provider Enrollment Manager opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.