Supervisor, Payer Enrollment & Reporting

WVU Medicine

Supervisor overseeing payer enrollment, credentialing, and delegated reporting for West Virginia’s largest health system. Managing staff, provider data, regulatory compliance, and payer operations.

Posted 8/5/2026full-timeRemote • Virginia, West Virginia • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in payer enrollment processes, compliance with NCQA, TJC, and CMS regulations, and effective supervision of enrollment and reporting staff. Proficient in managing credentialing databases and developing productivity standards while ensuring quality improvement and effective communication with stakeholders.

Highest-signal resume keywords

Payer Enrollment ManagementSupervisory ExperienceNCQA ComplianceCredentialing Database ProficiencyAnalytical Problem-Solving

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer EnrollmentCredentialing ProcessesRegulatory ComplianceReport GenerationQuality ImprovementData AnalysisWorkflow DevelopmentPerformance ManagementDocumentation StandardsProject Management

Soft Skills

Excellent CommunicationOrganizational SkillsAttention to DetailCollaborationProblem Resolution

Tools & Technologies

ECHO Credentialing DatabaseMS OfficeExcelOutlookWindows

Industry Keywords

Managed CareHealth Care IndustryCredentialingAccreditation StandardsDelegated CredentialingService BenchmarksRevenue Cycle OperationsConfidentialityProfessional ServicesPerformance Reviews

About the role

Key responsibilities & impact

Oversee centralized payer enrollment and reporting processes for facilities and providers
Supervise enrollment and reporting staff, including hiring, training, performance reviews, workload assignment, and problem resolution
Develop productivity standards, tracking reports, processes, and workflows
Supervise completion, submission, tracking, and follow-up for facility and provider applications
Advise the Director of Professional Services and notify administrators or VPs about enrollment issues and process breakdowns
Research enrollment requirements and ensure documentation complies with policies, regulations, and accreditation standards
Maintain credential database integrity and coordinate with IT and the software vendor to resolve issues
Oversee preparation of HPN rosters, ASO reports, provider profiles/rosters, and staff meeting reports
Supervise monthly system-wide enrolled-provider reporting for compliance and revenue-cycle operations
Ensure payer reporting compliance for more than 20 delegated-credentialing payers
Develop and maintain service benchmarks and quality-improvement programs
Communicate with payers to resolve authorization and billing denials related to participation status
Collaborate with medical staff leaders, hospital administrators, office managers, billing managers, departments, personnel, and customers
Maintain confidentiality, professionalism, attendance, punctuality, and a collaborative work environment

Requirements

What you’ll need

High School Diploma or GED required
Five years in managed care, physician’s office practice, or credentialing office
Seven years of health care industry experience
Two years of supervisory experience preferred
Extensive knowledge of the Director of Professional Services’ administrative responsibility areas
Expertise in NCQA, TJC, CMS, and state regulations related to enrollment processes
Knowledge of URAC, NCQA, and TJC standards
Proficient computer skills and thorough knowledge of Windows, MS Office, Excel, and Outlook
Ability to create, update, and run reports in the ECHO credentialing database or similar applications
Analytical and problem-solving skills with excellent attention to detail
Ability to work extended hours as needed
Ability to function in a demanding, fast-paced environment
Excellent organizational and prioritization skills; ability to manage multiple projects simultaneously
Ability to organize, delegate, direct, and review others’ work; apply laws, rules, regulations, policies, and procedures; create action plans; and manage implementation through completion
Excellent communication skills for interacting with influential internal and external contacts
Ability to maintain confidentiality

Benefits

Comp & perks

Full-time position
40 scheduled weekly hours
Exempt status