Director Provider Enrollment

Salary depends on experience
Posted on 02/23/18
5 - 7 years experience
Patient Care
Salary depends on experience
Posted on 02/23/18

Job Description

Summary: Oversees daily operational processes while creating policies and procedures to establish the most efficient and effective methods of providing enrollment services.

 

 

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

 

Maintains working knowledge of CMS regulatory and enrollment policies and procedures.

 

Maintains and improves Obsidian onboarding process.

 

Creates and introduces programs to assist in department morale if needed.

 

Interacts positively in a team environment, demonstrating superior teamwork, leadership skills, and customer service with all customers, (i.e. Department, Provider, Practice, Hospital, Division, etc.).

 

Continues to develop and coach departments’ managers and supervisors.

 

Identifies the need for performance improvement plans for team members not performing their duties in accordance with departmental policies and mission.

 

Monitors departments’ workload and creates a plan of action to redistribute as needed.

 

Establishes a system based upon benchmarks to address resources within the department and to assist in preparing the necessary justifications when necessary.

 

Develops and maintains a meeting with Division representatives regarding the status of enrollment activities and specifically each Division’s status of respective providers.

 

Monitors new physician acquisitions, (Transaction Status Report), and coordinates enrollment activities where applicable.

 

Comprises knowledge of delegated credentialing regulations.

 

Advises & recommends direction to local practice staff and/or hospital management regarding enrollment issues.

 

Prepare strategy for �best practice†of obtaining provider numbers from payers.

 

Must be fluent in all workings of Newport’s CARE Software program within the first 30 days, and continual communication with staff and user of system enhancements.

 

Any other assigned responsibilities as requested by VP Physician Operations not specifically noted above.

 

Job Requirements

Education and/or Experience: Bachelor’s degreedesired.  Minimum of 5 years successful experience in an administrative role (i.e. Management of 15+ FTE’s).  Desiredexperience in corporate setting with Health Care Company that oversees physician practices.  Working knowledge of Delegated Credentialing and NCQA requirements.  Experience with Microsoft Office, i.e., Excel and Word.  Working knowledge of Care system.

 

LANGUAGE SKILLS

 

·         English.

  • Ability to communicate with clarity both orally and in writing.

 

OTHER MISCELLANEOUS SKILLS

 

·         Superior Organizational Skills

  • Attention to Detail
  • Ability to Prioritize Assigned Projects
  • Demonstrate enthusiasm for the mission of the enrollment department and inspire the same in others.
  • Ability to break a complex problem down into its component parts and arrive at the appropriate solution in a timely fashion.
  • Act as Consultant & Advisor to Practice Contacts, Hospital CEO’s & Physicians
  • Ability to Exercise Sound Judgment
  • Ability to Make Independent Decisions

·         Ability to Manage Time without Immediate Supervision

·         Ability to Maintain Self Motivation

  • Possess a Desire for Excellence

 

PHYSICAL DEMANDS

 

·         Requires prolonged sitting.

  • Requires light lifting up to 10 pounds.
  • Requires eye-hand coordination and manual dexterity.
  • Requires the use of office equipment, such as computer terminals, telephones, faxes, photocopiers and postage machines.

 

WORK ENVIRONMENT

 

·         Work is performed in an office setting. 

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