USAManager, Enrollment
1 нед. назад
USALeadRemote
medicaremedicaidprovider enrollmentteam management
Lead and develop a large enrollment team managing provider enrollment applications for telehealth payers.
О компании
- We have a relatively flat organizational structure here at OpenLoop. Everyone is encouraged to bring ideas to the table and make things happen. This fits in well with our core values of Autonomy, Competence and Belonging, as we want everyone to feel empowered and supported to do their best work.
- Sound like a good fit? We’d love to meet you.
Обязанности
- OpenLoop's mission is to bring care anywhere by powering telehealth solutions at scale. The Enrollment team keeps our clinicians enrolled and in good standing with Medicare, Medicaid, and commercial payers across all 50 states — the foundation that lets patients see a covered clinician and get reimbursed care. As Manager, Enrollment, you'll lead a team of enrollment specialists who submit, track, and troubleshoot provider enrollment applications, and you'll own the harder problem behind the volume: figuring out why applications get denied and building the process to fix it.
- Manage and develop a team of 51 enrollment specialists, including US-based staff focused on government payer enrollment (Medicare and Medicaid) and a larger offshore team handling high-volume commercial payer enrollment across multiple states.
- Build out a management layer beneath you (leads/supervisors) as needed to maintain quality and coaching at this scale, and clarify escalation paths across the team.
- Build structure and prioritization into the team's daily workflow — set queues, deadlines, and accountability standards so applications are submitted accurately and on time.
- Own root-cause analysis on denied enrollment applications; investigate denial patterns, identify which can be corrected and resubmitted, and drive process changes that reduce the denial rate going forward.
- Hold payers accountable to expected turnaround and follow-up cadences; escalate and resolve stalled or at-risk applications.
- Serve as the primary point of contact between the Enrollment team and internal client-facing programs, translating enrollment status and blockers into clear updates for stakeholders.
- Partner cross-functionally with Revenue Cycle Management (billing and coding), Sales, the Manager of Payer Contracting, the Medical Staff Credentialing team, and Compliance/Legal to keep enrollment aligned with new contracts, provider onboarding, and regulatory requirements.
- Help build and manage a ticketing workflow (Jira) for the enrollment queue.
- Track and report on team throughput, application volume, and denial/approval trends.
- Coach and develop the team, set goals, manage performance, and support career growth.
- Other duties as assigned.
Требования
- 5+ years of experience in provider/payer enrollment, credentialing, or payer relations, with direct experience across both government (Medicare/Medicaid) and commercial payers.
- 2+ years of experience leading or supervising a large, high-volume operational team (ideally 25+ staff), including experience managing through sub-leads/supervisors rather than only direct 1:1s.
- Direct telehealth experience strongly preferred; comfortable with multi-state or multi-region private practice enrollment rather than a single hospital system or single-state network.
- Understands the practical differences between commercial, Medicaid, and Medicaid Advantage enrollment and how each is handled.
- Comfortable digging into denial and process data to find root causes, not just tracking application status.
- Working knowledge of enrollment and credentialing systems (e.g., MDStaff, CAQH, PECOS) and open to adopting new workflow tools like Jira.
- Excellent written and verbal communication skills; able to act as the connective tissue between the enrollment team, client programs, and other departments.
- Organized and detail-oriented, with a track record of building process and structure within a fast-moving team.
- 5+ years in provider enrollment, credentialing, or payer relations, with direct exposure to both government and commercial payers.
- Demonstrated people leadership experience, including performance management and team development.
- Experience with CAQH, PECOS, and/or similar credentialing and enrollment databases.
Будет плюсом
- Telehealth industry experience.
- Experience managing or partnering with a globally distributed (e.g., offshore) team.
- Experience implementing or managing ticketing/workflow tools such as Jira.
Условия
- Competitive compensation
- Medical, Dental & Vision
- Flexible Spending / Health Savings Accounts
- Generous PTO and hybrid-work flexibility
- 401(k) with Company Match
- Life Insurance, Pet Insurance, and more
Другое
- OpenLoop was co-founded by CEO, Dr. Jon Lensing, and COO, Christian Williams, with the vision to bring care anywhere. Our telehealth support solutions are thoughtfully designed to streamline and simplify go-to-market care delivery for companies offering meaningful virtual support to patients across an expansive array of specialties, in all 50 states.