Sr. National Enrollment Consultant

Company Description

Privia Health™ is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers.

Job Description

The Sr. National Enrollment Consultant will support the Credentialing & Enrollment team with complex matters. 

Primary Job Duties:

• Provide expertise to address any claims hold projects, including Medicare and Medicaid validation projects.
• Review and audit credential stream to ensure that no payers were missed
• Partner with market leaders to correct any payers missed 
• Handle complex government payer/enrollment issues such as Legal Entity name or any other type of change
• Work with managers to improve enrollment processes focusing first on the MA market.

Qualifications

• 5+ years experience with Medicare & Medicaid projects and payers
• Strong ability to communicate appropriately and effectively with practitioners, internal stakeholders, and providers; including sensitive and confidential information
• High level of attention to detail with exceptional organizational skills
• Exercise independent judgment in interpreting guidelines of applicable regulatory bodies.
• Demonstrated skills in problem solving and analysis and resolution
• Must comply with HIPAA rules and regulations

Colorado, New York, New Jersey, California and Washington Residents Only: The hourly range for this role is $75.00-$85.00 in base pay and exclusive of any bonuses or benefits. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location.

Additional Information

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.

Technical Requirements (for remote workers only, not applicable for onsite/in office work):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. Privia is a better company when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.