Payer Enrollment Supervisor
Core
Oversee end-to-end payer enrollment and maintenance lifecycle for individual and group providers, ensuring accuracy, timeliness, and compliance.
Role type
Senior operational supervisor (payer enrollment)
Builds
Provider participation with commercial payers
Domain
Healthcare administration / Payer operations
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Payer enrollment lifecycle management, CAQH profile maintenance, roster submission, commercial payer requirements knowledge, team supervision, process improvement, cross-functional collaboration, regulatory compliance, data integrity management, stakeholder communication
Preferred skills
Lead or supervisory experience, coaching and performance management, automation initiative leadership, analytical skills, organizational skills
Technologies
CAQH, NPPES, PECOS, CredentialStream, Salesforce, Zendesk, payor portals, credentialing software, ticketing systems
Responsibilities
Oversee end-to-end payer enrollment and maintenance lifecycle for individual and group providers; Supervise, coach, and support payer enrollment staff through workload oversight, training, performance management, and quality review; Serve as a subject matter expert on commercial payer enrollment requirements and participation standards; Oversee ongoing CAQH profile maintenance; Monitor enrollment applications, payer statuses, rosters, and effective dates; Communicate directly with commercial payers to clarify requirements and resolve issues; Collaborate cross-functionally with Credentialing, Contracting, Compliance, Legal, Provider Operations, Revenue Cycle, Billing, and other teams; Maintain accurate and complete enrollment records and documentation; Develop, implement, and continuously improve payer enrollment policies, procedures, workflows, and controls; Track and report enrollment metrics and key performance indicators; Lead process improvement and automation initiatives; Stay current on payer requirements, CAQH processes, state and federal regulations, and industry best practices
Seniority
Senior, hands-on IC with supervisory responsibilities