Director, Payor Enrollment

Thank you for considering a career at Ensemble Health Partners!

Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.

Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!

O.N.E Purpose:

• Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

• Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

• Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

The Opportunity:

By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare.

The Director, Payor Enrollment will be responsible for daily operations, ensure providers are appropriately enrolled with all health plans for all locations in which they practice. This role's objectives are to meet or exceed required turnaround times, quality goals, productivity goals, and to ensure consistency in payor enrollment performance. In addition, this individual will manage any external partners we work with for this work, as well as manage the release of claims, manage and monitor denials, with expected reductions of both areas. This position will work remotely and report to the VP, Revenue Cycle.

II. Job CompetenciesValuing Differences - Works effectively with individuals of diverse cultures, interpersonal styles, abilities, motivations, or backgrounds; seeks out and uses unique abilities, insights, and ideas. Considers the collective.Collaboration - Works cooperatively within teams and partners with others, both internally and externally as needed, to achieve success; focuses on the results of the team, not the achievements of one person. It’s “All for One and One for All”Accountability - Accepts personal responsibility and/or consequences of failure and successes, delivering on commitments and refocusing effort when needed. Someone who is willing to step up and own it.Time Management - Effectively manages personal time and resources to ensure that work is completed efficiently.Developing Trust - Gains others’ confidence by acting with integrity and following through on commitments; treats others and their ideas with respect and supports them in the face of challenges.Takes Initiative - Takes prompt action to accomplish goals and achieve results beyond what is required; is proactive and pursues relentlessly.III. Essential Job Functions

Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.

Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.

Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.

Develop and execute a strategic plan for payor enrollment, ensuring timely and accurate enrollment in all relevant healthcare networks.

Coordinate with various departments to gather necessary documentation and information for enrollment applications.

Stay updated on changes in payor requirements and regulations to ensure ongoing compliance.

Oversee and lead the credentialling/payor enrollment process for healthcare providers within the organization, ensuring compliance with industry standards and accrediting bodies.

Manage the preparation and submission of credentialing applications to payors, ensuring accuracy and completeness

Collaborate with medical staff offices to maintain provider enrollment files and ensure timely renewals.

Build and maintain positive relationships with payor representatives to facilitate smooth enrollment and credentialing processes.

Act as the primary point of contact for payor inquiries and issue resolution related to enrollment and credentialing matters.

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