The Provider Enrollment Manager is responsible for managing the CBO activities of the Region to ensure effective operations, compliance with government/state regulations, and that all Pediatrix physicians, nurse practitioners, physician assistants and certified nurse midwives are appropriately credentialed with licensing agencies, hospitals, and health plans.

• Manage enrollment activities to ensure accurate and timely enrollment of our providers on appropriate health plans
• Manage acquisitions as related to gathering of appropriate provider data and documents and all credentialing and enrollment
• Coordinate assignments, work flow and establishes priorities on a daily basis for employees
• Monitors data collection process and analyzes information received for physicians and nurse files
• Develop and maintain all policies and procedures for department processes and revise as needed
• Develop reports to various department managers and staff to discuss issues, obtain feedback and disseminate information regarding credentialing issues
• Coordinate and participate in the âœdelegated credentialing❠process with managed care companies, including annual audits
• Plan, prepare and implement department budget
• Interview prospective employees, coordinate orientation, manage employee performance, counsel employee and implement corrective action, schedule staff and time off
• Evaluate and perform annual performance appraisal for each employee
• Manage process of establishing timelines for office-based practices and participate in meetings with managers of these practices
• Communicate with Information Management, Managed Care, and Risk Management as it related to all license, privilege, and health plan enrollment issues, including malpractice insurance, provider group/pin numbers, and new health plan contracts

Education/Experience:

• Bachelorâ™s Degree required.
• 4 years provider enrollment experience required
• Minimum 2 years management experience required.
• Knowledge of credentialing standards, which includes state and federal regulations as well as hospital regulations and NCQA standards required.

Benefits for Full Time employees and qualified dependents:

• Medical, Prescription, Dental, Vision Insurance
• Progyny Fertility Benefits
• Livongo Diabetes Management
• Teladoc Health and Second Opinion Services
• Smart Shopper
• 401(K) Thrift Program & Sharing Plan**
• Employee Stock Purchase Plan (ESPP) â“ 15% discount*
• Basic Employee; Spouse; Child Life Insurance
• Accidental Death and Dismemberment (AD&D)
• Employee Optional Life and AD&D
• Short & Long Term Disability
• Pre-Tax Health Savings Accounts (HSA)
• Employee and Dependent Flexible Spending Account (FSA)
• Family Medical Leave Act (FMLA)**
• Parental Leave Benefit
• Sick Pay Bank
• Employee Assistance Program (EAP)**
• Group Aflac Policies
• Identity Theft Protection
• Employee Charitable Fund
• Care.com
• Various Discount Programs

*Part Time Regular employee classifications also receive this benefit

**Available to part-time regular and part-time casual employees aged 21 and over

Pediatrix Medical Group is one of the nationâ™s leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The groupâ™s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives.

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.

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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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About Pediatrix Medical Group

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