Medicare & Medicaid Provider Enrollment- Assistant Manager

Posted Date 2 weeks ago(3/1/2018 6:56 PM)
Job ID
# of Openings
Full Time Regular



Medicare & Medicaid Provider Enrollment 

Assistant Manager 


The Assistant Provider Enrollment Manager will supervise all aspects of Matrix Medical Network’s government healthcare provider enrollment and state specific licensing enrollment.  Responsibility of the Assistant Manager will include ensuring that Matrix Medical Network is in 100% compliance with all Medicare and Medicaid enrollment and participation regulations and guidelines.  Responsibility will also include Matrix Medical Network timely and accurately submits state specific license application to the appropriate Medical or Nursing Board.


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The Assistant Provider Enrollment Manager at Matrix Medical Network will provide assurances to the organization and client health plans that providers are appropriately and adequately enrolled in Medicare and Medicaid and licensed by the appropriate Medical of Nursing Board.

The position interacts with leadership at all levels within the organization and works closely with Credentialing team members and leadership along with Production, Planning & Control and Clinical Recruitment as needed for projects.


  • Leads all aspects of the Government Enrollment and Licensing team including process improvement initiatives and implementation of processes to improve efficiency and effectiveness of the team.  Meets or exceeds all personal and department Key Performance Indicators (KPI’s).
  • Oversees the 100% accurate and 100% timely compliance of government provider enrollment and state specific license applications and updates.
  • Ensures that the Provider Enrollment team is implementing and following all policies and procedures to ensure efficiencies and compliance with the applicable government and licensing agencies.
  • Provides direction and training to staff to ensure department meets production and quality assurance goals defined for this position.  Provides assistance to other Matrix departments and works closely with the Legal department in developing submission material to government agencies with respect to Medicare and Medicaid regulations.
  • Responsible for oversight of all Medicare and Medicaid regulations including staying abreast of new guidelines and their ramifications to Matrix Medical Network as well as developing new policies and procedures to support new or changing regulations
  • Establish leadership, structure, policies and procedures, monitoring and oversight processes to ensure overall and optimal provider experiences
  • Oversight of Credentialing and Enrollment management team and applicable team members
  • Actively participate in client meetings to identify improvement opportunities promptly and continue to enhance operations and provider experience
  • Develop training materials for internal staff and business partners
  • Establish and review reporting timeframes – cycle time, processing time, team and staff level SLAs, credentialing activities and enrollment/revalidation activities
  • Work with the Quality and Training team to develop and implement appropriate training strategies for the team
  • Support continuous improvement of employee engagement and morale
  • Complete 1:1 meeting with each team member on at least a monthly basis. 

Supervisory Responsibility: There will be direct supervisory responsibility with this role.


Travel Requirements: <25%



Work Conditions: General office environment.


Education Requirements

  • Bachelor's degree healthcare related field or related experience required.


Required Skills and Abilities

  • 3+ years management experience
  • 3+ year's work experience with process/quality improvement activities
  • Demonstrated leadership capabilities, including driving team performance
  • Ability to effectively manage office based and remote staff
  • Strong data analytical skills with the ability to leverage best practices
  • Ability to build and maintain relationships
  • Experience with the provider enrollment process for Medicaid, Medicare and Licensing
  • Excellent communication skills – verbal and written
  • Ability to present complex data clearly and concisely to internal and external clients
  • Highly driven and ability to be flexible and adaptable
  • Strong knowledge of NCQA, URAC, and state rules and regulations
  • Handle individual workload and deliver upon project milestones on time.
  • Consistent demonstration of high integrity, self-motivation and proactive thinking and approach, without requiring direction from leadership.
  • Ability and comfort with navigating ambiguous situations, thinking outside the box, and coming up with creative solutions to problems.


Core Competencies

  • Analytical Thinking
  • Computer Skills
  • Critical Thinking
  • Self-Direction
  • Timely Decision Making


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