Manager of Provider Enrollment Operations

2 weeks ago

Gainesville, Florida, United States UF Health Full time

Overview:

The Manager of Provider Enrollment Operations oversees the daily functions of the Provider Enrollment process within the UF Health System. This role is pivotal in guiding the provider enrollment activities through Medical Staff Administration, ensuring that management teams, staff, and counterparts are well-informed and directed. Key responsibilities encompass staff management, project oversight, meeting facilitation, educational initiatives, and the financial outcomes associated with EPIC assignments.

Key Responsibilities:

  • Conduct daily, weekly, and monthly evaluations of the enrollment team's performance.
  • Maintain and report audit results to the Director of Medical Staff Administration.
  • Manage departmental timekeeping in Kronos to ensure adequate coverage.
  • Plan and execute projects, establish goals, assess staffing needs, and set timelines.
  • Implement projects and delegate detailed tasks to departmental staff, ensuring timely completion.
  • Develop and update policies to align with provider enrollment processes and maintain the provider enrollment manual.
  • Optimize team resources and workflow to enhance efficiency and productivity.
  • Analyze payor trends related to team members' assigned departments and address any revenue and enrollment issues.
  • Provide guidance to the team in prioritizing tasks and responsibilities.
  • Create and implement educational modules for both new and existing staff, covering Medical Staff Administration topics.

Primary Contact:

Act as the main liaison for Federal and State health plans regarding enrollment issues, facilitating resolutions as necessary. Ensure quality accounts receivable outcomes by reviewing assigned EPIC accounts and reporting trends and issues to the Director of Medical Staff Administration and Billing and Accounts Receivable.

Collaboration:

Work collaboratively with various departments, including Billing/Accounts Receivable, Legal, IT, and Regional Programs, to mitigate ongoing procedural challenges affecting the satisfaction and quality standards of the UF Health System. This role requires extensive interaction with medical and administrative leadership, clinical department administrators, and external Federal and State agencies.

Qualifications:

Minimum educational requirements include a Master’s degree in Health Administration, Business Administration, Public Health, or Information Technology with two years of relevant experience, or a Bachelor’s degree with three years of relevant experience, or five years of experience in medical staff administration or provider enrollment. Candidates should possess a comprehensive understanding of provider billing and enrollment requirements, as well as medical staff accreditation standards. Proficiency in computer applications such as Word, Excel, and Adobe Professional is essential, along with familiarity with relational databases in a medical staff context.

Skills:

Exceptional verbal and written communication skills, project management capabilities, training experience, analytical and organizational skills, and the ability to manage multiple priorities are crucial for success in this role. Additionally, candidates will serve as a liaison for all credentialing matters, including audits and regulatory surveys.

Licensure/Certification:

Certification as a Certified Professional Medical Staff Manager or Certified Provider Credentialing Specialist is required. Experience with MSOW web-based software is preferred.

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