Senior Manager, Regulatory Compliance - Provider Enrollments

Why Us?

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

Could This Be For You?

We are seeking a Senior Manager, Regulatory Compliance - Provider Enrollments - Remote who is responsible for providing direct strategic and administrative leadership and supervision to the Regulatory Compliance Enrollments and Credentialing Team.  The ideal candidate will have experience with multi-site, multi-state Medicare/Medicaid enrollment from DME, PT/OT, homecare, radiology/imaging, dialysis or similar service providers.  Responsible for developing and implementing Hanger Clinic initiatives to monitor compliance with state licensure and Medicaid regulatory requirements related to Hanger Clinic DMEPOS services and enrollments. Develops, implements and monitors Medicaid compliance for clean enrollment submission.  Evaluates staff resource allocation and provides input to senior management on program’s budget needs. Identifies and implements tools for efficient processing, tracking and communication of enrollment statuses, maximizing currently available tools within the enterprise.  Responsible for the supervision of the tracking, completion, and submission of clean Medicare/Medicaid applications based on the needs of Hanger Clinic.  Oversees related acquisition integration activities for smooth transition of acquired entities into the Hanger ecosystem for continuity of patient care, provision of service and payor reimbursement.

Performs research on Medicaid requirements and related regulatory requirements.  Engages with regulators and serves as management liaison to resolve potential issues and escalates as needed.   Assists with written responses to regulatory inquiries coordinating submission with Chief Compliance Officer. Works closely with Enterprise Compliance and Legal Teams, to assist in interpretation of regulatory changes and related implications. Provides consultation and training on Medicaid regulations and across Hanger Clinic.  Consults with field staff on enrollment application process for state level clinical services based licensure and Medicaid services. Supports and validates DME/pharmacy licensure requirements and enrollment submissions.  Candidate must have excellent presentation and communication skills, ability to represent Hanger at external events (client and national association meeting) and diffuse difficult situations.  Must be able to analyze and troubleshoot the needs of the customer with a sense of urgency, while maintaining or exceeding established productivity and quality standards.

Your Impact

• Establish, maintain, and oversee state DMEPOS licensure, credentialing and enrollment functions required for compliant billing to all payers such as: Medicare, Medicaid, VA, commercial carriers
• Review new enrollment requirements in accordance with related regulations impacting on DMEPOS across all Hanger Clinic locations
• Train staff across organization on new regulations and track implementation as needed
• Create processes and tracking mechanisms to identify new regulations impacting on DMEPOS enrollments
• Oversee direct reports to complete Medicare/Medicaid applications/obtain licenses accordingly. Able to complete applications if needed.
• Interpret/analyze regulations and other requirements, in partnership with Legal and Compliance Regulatory teams

Minimum Qualifications

• 5+ years of related experience in multi-site, multi-state Medicare/Medicaid enrollment, DMEPOS preferred
• Bachelor’s degree in business administration or related healthcare field
• 5+ years Supervisory/Management experience
• Demonstrated ability to communicate with and influence regulators
• Knowledge of legislative and regulatory processes and applicable impact on DMEPOS
• Demonstrated knowledge of current trends and developments in healthcare reimbursement environment
• Demonstrated ability to lead & manage through influence & change
• Strong interpersonal skills emphasizing flexibilit