Vice President, Revenue
Shiftsmart
Director, Payer Enrollment
Medallion
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $130,000 - $180,000 per year
Job Level
Lead
About the role
- Develop and manage Payer Enrollment leaders at various levels of professional tenure
- Mentor direct reports via 1:1s and reviews to grow their skills
- Support measuring and planning for the team’s performance, capacity, and growth targets
- Implement new and optimize existing tools, processes, systems, and products to streamline Payor Enrollment work and increase efficiency/accuracy (standardized playbooks, communication templates, training materials, resource guides, automation features, advanced tooling)
- Work with internal and external stakeholders to resolve complex provider enrollment issues
- Own, measure, and provide insights on renewal forecasts, customer health, customer surveys, and product usage
- Serve as primary point of contact for customer-facing issues related to overall performance and quality; resolve escalations
- Manage and improve systems that support the team’s processes (Medallion proprietary systems, Front, GSheets, Salesforce)
- Design and conduct training regarding provider enrollment processes and process improvement initiatives
- Continuously learn industry best practices and introduce ideas to drive efficiency, growth, and customer outcomes
- Direct ownership over Medallion’s Payer Enrollment function to drive operational excellence and cost efficiency
- Report directly to the Senior Director of Operations
Requirements
- 10+ years of experience in payer enrollment, with a focus on enrolling providers with multiple payers, including commercial, Medicaid, and Medicare
- Proven ability to manage high-volume enrollments (5,000+ enrollments monthly) across multiple payers
- Minimum of 5 years in a leadership role managing payer enrollment teams or related operational functions
- Experience working with healthcare providers and understanding of credentialing processes
- Proficiency with enrollment and credentialing software tools (e.g., CAQH, PECOS, Availity, or other payer portals)
- Familiarity with workflow automation tools and software to streamline payer enrollment processes
- Strong data analysis skills to assess enrollment trends and performance metrics
- Thorough understanding of payer enrollment processes, payer contracts, regulatory requirements, and compliance
- In-depth knowledge of Medicaid, Medicare, commercial insurance plans, and third-party administrators
- Strong problem-solving and decision-making skills for complex payer enrollment challenges
- Excellent communication skills to liaise between providers, internal teams, and external payers
- Experience with systems such as Front, GSheets, Salesforce (current systems referenced)
- Certifications preferred: CPCS or CPMSM (consider requiring or preferring)
- Established relationships with payer representatives and industry associations (industry network)
- Experience managing large-scale disruptions (payer policy changes) with resilience and minimal customer impact
- Comfortable conducting performance analysis and driving KPI-based improvements
