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Director, Provider Enrollment
Ventra Health. Direct and manage the Provider Enrollment department’s day-to-day operations .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in managing provider enrollment operations, including oversight of the enrollment lifecycle, financial reporting, and healthcare data analysis. Strong leadership and communication skills are essential for developing team capabilities and maintaining client relationships.
Highest-signal resume keywords
Provider Enrollment ManagementHealthcare Data AnalysisFinancial ReportingSupervisory ExperienceMedical Terminology Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Provider Enrollment RequirementsPhysician BillingHospital BillingVendor ManagementBusiness ProcessesFinancial ProcessesMedical Record DocumentationData AnalysisPresentation DevelopmentDecision-Making
Soft Skills
Leadership DevelopmentTeam BuildingInterpersonal CommunicationProblem-SolvingTime Management
Tools & Technologies
CAQH DatabaseNPI WebsiteEDI ProcessesEFT ProcessesERA Processes
Industry Keywords
Provider Enrollment LifecycleCredentialing DeliverablesClient RelationshipsManagement ReportsOrganizational Needs
About the role
Key responsibilities & impact- Direct and manage the Provider Enrollment department’s day-to-day operations
- Recruit, select, orient, train, coach, counsel, and discipline staff
- Develop relationships with Provider Enrollment teams and document organizational needs and priorities
- Oversee the provider enrollment lifecycle, including new enrollment, reenrollment, enrollment denials, and client-level special projects
- Monitor client-level metrics and ensure timeliness and accuracy of enrollment activities
- Develop client relationships and provide regular status updates on credentialing deliverables
- Recommend workflow improvements throughout the enrollment cycle
- Develop and recommend policies and guidelines and implement procedures for consistent department-wide adherence
- Hold management meetings to review held claims, client provider enrollment status, and provider enrollment inventory
- Monitor department activities, identify gaps, and implement processes to improve timeliness and effectiveness
- Compile and prepare management reports to analyze trends and make recommendations
- Perform special projects and other assigned duties
Requirements
What you’ll need- High School diploma or equivalent
- At least five (5) years of physician billing, hospital billing, or vendor management experience in provider enrollment functions
- Knowledge of provider enrollment requirements for physician billing and multi-state experience preferred
- Knowledge of business and financial processes and procedures
- Knowledge of medical terminology and anatomy
- Knowledge of medical record documentation requirements
- Strong supervisory/management skills
- Strong leadership development and team building skills
- Strong management-level oral, written, and interpersonal communication skills
- Strong financial reporting skills
- Strong healthcare data analysis skills
- Strong presentation development and delivery skills
- Strong word processing, spreadsheet, database, and presentation software skills
- Strong decision-making, problem-solving, organizational, time management, and mathematical skills
- Ability to present financial reporting and healthcare analytics to executives, managers, clients, and customers
- Ability to adapt communication style to different audiences
- Ability to communicate professionally with business stakeholders and IT staff
- Ability to identify recurring issues and solve front-end issues
- At least two (2) years of supervisory/management/leadership experience preferred
- Experience with CAQH database, NPI website, and maintaining EDI, EFT, and ERA processes preferred
Benefits
Comp & perks- Ventra performance-based incentive plan
- Discretionary incentive bonus in accordance with company policies
- Referral bonus
- Reasonable accommodations for qualified individuals with disabilities