Community Health Systems is one of the nation’s leading healthcare providers. Developing and operating healthcare delivery systems in 48 distinct markets across 16 states, CHS is committed to helping people get well and live healthier. CHS affiliates operate 83 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers.

Summary:

Under the direction of the Director of Provider Enrollment, the Manager of Provider Enrollment is responsible for the daily activities of a team of Provider Enrollment Specialists focused on commercial and government payer enrollment activity for assigned market(s).

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Provides direct leadership for provider enrollment team members and performs workload management through planning, prioritizing, and assigning work according to shifting priorities.
• Serves as subject matter expert for provider enrollment activities and handles escalated issues related to provider enrollment.
• Ensures the timely submission of enrollment applications and revalidations with the payers, including all appropriate follow-up measures.
• Communicates with various payers, clinics, billing offices, practitioners, and leadership regarding the status of enrollments on an ongoing basis as the primary contact for all enrollment-related issues.
• Facilitates regular market enrollment calls regarding new providers, new practice locations, upcoming acquisitions, and various other enrollment activities
• Ensures that the department is up to date regarding current payer enrollment requirements and processes in order to minimize enrollment delays.
• Creates and maintains effective training programs, policies, and procedures to comply with regulatory requirements and to ensure best practice adoption.
• Develop process improvement solutions to enhance productivity and performance; supporting identification of operational gaps, risks, and issues, opportunities for efficiencies and strategies for process improvement; developing short and long term solutions, monitoring action plans
• Recruit, develop, and motivate staff, while optimizing the experience, skill, knowledge and capability; analyze reports to accurately forecast staffing/resource requirements; serve as focal point within enrollment for issues related to performance and impact.
• Provide clear direction for staff by establishing goals, objectives, policies, procedures, performance improvement programs, and action plans as needed. Performs all hiring, training, coaching, auditing and evaluations of Provider Enrollment staff. Supervises enrollment staff and workflow including guidance and training for staff
• Assist with other departmental projects as needed

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of word processing software, spreadsheet software, and database software.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.
• Must be self-motivated and able to communicate well with others in person, via written communication, and telephonically.
• Must be able to perform each essential duty satisfactorily.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Reasoning Ability:

Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

Computer Skills:

To perform this job successfully, an individual should have knowledge of Word Processing software; Spreadsheet software and Database software.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

Bachelor’s degree in business management or healthcare administration preferred; 5 years of provider enrollment/credentialing experience.