Provider Enrollment Manager - Department Promotion

Job description

Under general direction of and in cooperation with the Director of Heath Care Agency (HCA) Medical Staff Administration, the Provider Enrollment Manager will oversee the systems for third party plan payor enrollments throughout the HCA.

IDEAL CANDIDATE

The ideal candidate will be an effective manager who maintains a professional, pleasant, and respectful demeanor with all levels of staff in a fast-paced environment. This person will have strong communication, interpersonal, and administrative/office skills, as well as substantial experience with third party payor enrollments and interpreting practitioner and payor contracts.

EDUCATIONAL/BILINGUAL INCENTIVE

Possible educational incentive of 2.5%, 3.5%, or 5% based on completion of Associate's, Bachelor's, or Master's degree. Incumbents may also be eligible for bilingual incentives depending upon operational need and certification of skill.

PAYROLL TITLE

Program Administrator II

Program Administrator II is a management classification and is not eligible for overtime compensation. Incumbents in these classifications are eligible for benefits at the MB4 level.

AGENCY/DEPARTMENT

Health Care Agency – Ventura County Medical Center/Santa Paula Hospital

The eligible list established from this recruitment may be used to fill current and future Regular, Temporary, Fixed-term, Intermittent, or Extra Help vacancies for this position only. There is currently one (1) Full-time Regular vacancy.

TENTATIVE SCHEDULE

OPENING DATE: 9/28/2026

CLOSING DATE: 10/9/2026

Duties may include but are not limited to the following:

Manages/oversees the provider enrollment operations with private and government payors;

Oversees the efficiency and accuracy of the provider enrollment vendor activities and billing processes;

Oversees the monthly health plan rosters and timely communication of roster changes;

Manages and maintain database provider enrollment records in MDStaff;

Collaborate with the Hospital Medical Staff credentialing team regarding provider data necessary for timely payor enrollments;

Monitors and investigates payor denials related to enrollments and roster discrepancies;

Develops/manages department enrollment policies & procedures;

Manages distribution and attestation process of health plan specific orientation/training requirements;

Maintains documents related to enrollments and the provider enrollment applications;

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Worksite address

ventura, CA, 93006, US

Who can apply

Review the original listing for work authorization, qualifications and employer requirements.