Analyst, Provider Enrollment

Provider Enrollment Analyst

MDVIP is a national leader in personalized healthcare, empowering over 425,000 members to achieve their health and wellness goals through a network of more than 1,400 concierge primary care physicians. Our program emphasizes preventive medicine, offering comprehensive screenings, advanced diagnostics, and individualized wellness plans. Recognized as a Great Place to Work since 2018, MDVIP is committed to excellence in patient care and employee satisfaction.

MDVIP is seeking a Provider Enrollment Analyst reporting to the Manager of Insurance Programs, to manage the insurance provider enrollment process for our MDVIP physician affiliates. This role requires a deep understanding of credentialing & contracting procedures and the ability to provide accurate guidance and support to affiliated physicians, physician staff and internal teams.

If you have a thorough understanding of managing provider enrollment and are a critical thinker, we want to meet you.

You'll coordinate with and support the Insurance Services Department in the resolution of complex or advanced issues and cases. As the Provider Enrollment Analyst, you'll serve as a liaison between MDVIP and insurance carriers, commercial and federal clearinghouses, and regulatory bodies at the state, county, and federal levels. Additionally, you will ensure compliance with all licensing and credentialing requirements on behalf of MDVIP affiliated physicians.

Key Responsibilities

• Manages non-standard provider enrollment workflows, interpreting payer-specific contract requirements and independently navigating complex scenarios that fall outside templated enrollment processes.
• Accountable for end - to - end provider enrollment and contracting coordination through completion, delivering responsive, high - quality service while proactively educating physicians on timelines, managing expectations, and maintaining strong partnerships as operational challenges arise.
• Serves as the primary liaison and subject - matter expert for provider enrollment, collaborating across physicians, internal stakeholders, and external partners to drive alignment, quality, operational readiness, and a consistently high standard of service across credentialing and contracting workflows.
• Complete statewide credentialing applications to establish new groups and add providers to commercial payers and Medicare
• Serves as the authoritative steward of provider enrollment data. Conducts detailed analysis and reconciliation of provider enrollment information across multiple systems, proactively identifying discrepancies, downstream risks, and potential impacts to revenue, access, or compliance.
• Maintain provider enrollment system processes, policy and procedures, ensuring adherence to all requirements and taking corrective steps as needed.
• Exercises independent judgment to resolve enrollment obstacles and exceptions, escalating only high-risk, systemic, or time-sensitive issues with clearly defined solution options and impact assessments.
• Maintains operational and regulatory integrity of provider enrollment data by independently managing, validating, and reconciling complex provider records across high-volume, payer-specific enrollment workflows.
• Provide training and guidance to affiliates, physician staff or respective billing companies related to MDVIP, when requested, on preventive billing protocols and/or provider enrollment needs

Metrics & Reporting

• Develop, analyze, and distribute timely, status reports to affiliated physicians and field staff; proactively manage follow-ups to ensure resolution and closure of all outstanding cases.
• Compile, validate, and deliver comprehensive insurance-related reports and management presentations, translating complex data into clear insights to support decision-making and operational planning.

Escalation & Urgent Issues

• Conducts detailed analysis and reconciliation of provider enrollment data to support accurate contracting, payer submissions, and ongoing network compliance, while managing complex, non-standard enrollment scenarios.
• Independently identifies, evaluates, and synthesizes complex enrollment and contracting issues, delivering clear root-cause analysis and actionable recommendations to management. Resolves escalated issues and urgent requests.

Key Competencies

• Successful track record in a similar corporate role focused on coordination or management of provider enrollment.
• Interprets complex data using experience and critical thinking to support insights.
• Builds collaborative, productive relationships with physicians, physician staff and stakeholders.
• Communicates clearly, professionally, and effectively across diverse audiences.
• Proactively identifies solutions, pursues growth, and seeks added responsibility.
• Demonstrates accountability, meets deadlines, and maintains daily preparedness.
• Applies strategic thinking to assess risks, trends, and opportunities for informed decision-making.

Requirements

Minimum Qualifications

• Associate's degree and at least two (2) years related business experience
• Four (4) years of related work experience.
• Familiarity with EMR and credentialing software.
• Proficient in Microsoft Office applications.

Preferred Qualifications

• Experience with CAQH, PECOS & NPPES applications.
• Experience with Net Docs, credentialing software, and athena.
• Certified Provider Credentialing Specialist (CPCS).
• Certified Provider Enrollment Specialist (CPES).
• Experience with Salesforce or other CRM tools.

Why Join MDVIP?

• Be part of a mission-driven organization leading innovation in personalized healthcare.
• Drive transformation and growth in a dynamic, fast-paced environment.
• Competitive compensation: attractive base salary complemented by performance-based incentives for eligible roles.
• Comprehensive benefits: health, dental, vision insurance, and retirement plans.
• Professional development: access to ongoing training and leadership development programs.
• Positive work environment: consistently recognized as a Great Place to Work, fostering a culture of collaboration and excellence.

MDVIP is an Equal Opportunity Employer and is committed to fostering an inclusive and diverse workplace. We welcome applicants of all backgrounds and do not discriminate based on race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, veteran status, or any other protected status. We believe that diversity and inclusion drive innovation and strengthen our company culture.

If you require accommodation during the application or interview process, please let us know, and we will be happy to assist.

Pay Transparency: Our compensation reflects the cost of labor across appropriate US geographic markets. Pay is based on several factors including but not limited to market location and may vary depending on job-related knowledge, skills, and education/training and a candidate's work experience. Hired applicants are offered annual incentive compensation programs, subject to applicable eligibility requirements. Payments under these annual programs are not guaranteed and are dependent upon a variety of factors including, but not limited to, individual performance, business unit performance, and/or the company's performance. The company offers the following benefits for this position, subject to applicable eligibility requirements. Medical/prescription drug coverage, Dental coverage, Vision coverage, Flexible Spending Account, Health Savings Account, Dependent Care Flexible Spending Account, Basic and Supplemental Life Insurance & Accidental Death and Dismemberment, Disability Income Protection Plan, Employee Assistance Program, 401(k) retirement program, Vacation, Paid Holidays and Personal time, Paid Sick and Family and Medical Leave time as required by law.

MDVIP Practice Management