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Non-Clinical
📅
19003695 Requisition #
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Grady Health System offers many career paths. Whether you have many years of experience or are in the early stages on your career, you can find a rewarding position at Grady!

   

SUMMARY

    

The Manager Enrollment is responsible for the successful operation of the assigned business unit. This individual will oversee day-to-day operations, implement the strategic vision of the department and support the development and achievement of Department and organizational goals.

   

Under the direction of the Director Managed Care and Payer Strategy, coordinates the process for Health System and employed physician enrollment for the managed care organizations. Manages projects and facilitates resolution to issues related to enrollment, and contract performance. Serves as a liaison resolving issues between the Health System, employed physician group practices, hospital/physician billing, and health plans. Oversees the Health System and physicians' rights and obligations under each managed care contract and ensures managed care companies fulfill their contractual obligations. Manager Enrollment collaborates effectively with co-workers and other departments to ensure quality service to our internal and external customers. Maintains a positive approach to issues and concerns as they arise, and works to identify and recommend process improvements to his/her direct supervisor/manager.

   
 QUALIFICATIONS   

  • Bachelor’s degree or relevant certification.

  • Master’s degree in related field.

  • 3-5 years’ progressive management experience in payer enrollment, credentialing and the healthcare revenue cycle.

  • EPIC or other relevant software and technology.

  • Knowledge of hospital financial, reports, and tools.

  • Analytical and problem solving skills.

  • Problem solving skills to approach new regulations and situations with an imaginative, innovative, and analytical skill.

  • Advanced proficiency with Microsoft Office products (Word, Excel, PowerPoint).

  • Knowledge Lean/Six Sigma preferred.

  • Previous managed care experience preferred.

  • Previous enrollment process for the managed care organizations.

  • Extensive knowledge of HCPCS, ICD, CPTs, Revenue Codes, DRG, payment methodologies, and managed care operations.

  • Previous enrollment process for the managed care organizations.

  • Proven work record that demonstrates in depth knowledge of hospital and physician billing and reimbursement.

  • Ability to compile data, analyze, report data, and make decisions that support department and Health System objectives.


    Equal Opportunity Employer-Minorities/Females/Veterans/Individuals with Disabilities/Sexual Orientation/Gender Identity.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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