Manager Provider Enrollment

Manager Provider Enrollment

System Overview:

Steward Medical Group, headquartered in Boston, is a community-based accountable care organization and community hospital network with more than 15,000 employees serving more than one million patients annually in 85 communities.

Description:

Oversee the Provider Enrollment and Credentialing for Steward Medical Group. Provide supervision and direction to the Provider Enrollment personnel to ensure the timely credentialing of physicians and mid level practitioners with third party payers.

Duties include but not limited to:

• 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 coding staff
• Supervises coding staff and workflow including guidance and training for staff
• Manage the process to ensure the timely submission of re-credentialing documentation for each provider
• Direct the process to ensure the timely submission and follow up of contracts and documentation with the payers to ensure that each provider is billing ready upon the commencement of their employment
• Responsible for quality and productivity metrics directly related to Provider Enrollment tasks
• Actively and continuously analyzes workflows, organizational structure, staffing assignments or other factors to ensure optimal performance; makes recommendations and modifications, as necessary. Focus on continuous improvement
• Oversee maintenance and updating of Provider Enrollment Databases
• Ensure compliance with state and federal regulations, and policies & procedures
• Play a significant role in long-term planning, including an initiative geared toward operational excellence

Qualifications:

• Bachelors Degree Preferred
• Three to five years progressive work experience in provider enrollment, physican practice credentialing and practice accounts receivable management in a management position
• Working knowledge of Intellicred and/or AthenaHealth practice management system strongly preferred
• Excellent interpersonal skills and a collaborative management style
• Ability to work will with all levels of personnel
• Ability to communicate effectively, both orally and in writing
• Excellent PC based application skills including Excel, Access and Word
• Ability to prioritize effectively in a high volume environment

Steward Medical Group is an equal opportunity employer