Payer Enrollment Manager, Healthcare Revenue Cycle

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September 24

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Guidehouse

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Consulting • Digital Services • Public Sector

Guidehouse is a global consultancy offering advisory, digital, and managed services across commercial and public sectors. It is purpose-built to support industries such as national security, financial services, healthcare, energy, and infrastructure. Guidehouse collaborates with leaders to navigate complexity and drives transformational changes that impact the future. Their expertise spans data analytics, digital technologies, risk management, and more, with a strong emphasis on sustainability and innovation.

10,000+ employees

Founded 2018

💰 Grant on 2023-02

📋 Description

• Lead and oversee payer enrollment operations across UAB Medicine, UAB St. Vincent’s, and affiliated entities • Manage both delegated and direct enrollment functions, payer relationships, and system integrity • Coordinate projects and issues with the MDSO and Managed Care Contracting and staff performance across multiple teams • Serve as the primary operational and strategic leader ensuring efficient and compliant enrollment of providers with government and commercial payers • Partner with Revenue Cycle leadership, contracting, and credentialing teams to align enrollment efforts with organizational priorities • Serve as the key representative in planning meetings, payer strategy sessions, and system initiatives • Directly manage the MSO Enrollment team and Payer Enrollment staff supporting affiliated organizations; supervise Enrollment Leads and MSO Enrollment Supervisor • Oversee staffing models, resource allocation, and establish structure and accountability for supervisory-level staff • Manage delegated roster submissions, direct enrollment workflows, recredentialing, demographic updates, and compliance-driven enrollment maintenance tasks • Serve as the primary operational escalation point for provider setup, billing delays, or denials related to enrollment • Lead system oversight and optimization for MD-Staff and ensure continuity of Symplr usage during transitions • Partner with system teams to align Athena One, IDX, and Epic for billing readiness, enrollment holds, and denial resolution • Represent the enrollment function in Revenue Cycle leadership meetings and payer operations workgroups • Collaborate with AR follow-up, billing teams, MDSO, CVO, Managed Care Contracting and other stakeholders to resolve payer enrollment-related issues • Develop, maintain, and enforce standard operating procedures; identify opportunities for automation, reporting, and workflow redesign • Track KPIs and prepare leadership reports on enrollment status, backlog, processing timelines, and issue resolution trends • Ensure all delegated enrollment activities meet contractual obligations and are audit ready

🎯 Requirements

• Requires a Bachelor's Degree and a minimum 7 years of prior relevant experience OR Associate's Degree and a minimum 9 years of prior relevant experience • Relevant experience may be substituted for formal education or advanced degree • At least three (3) years in payer enrollment, credentialing, or managed care operations • Relevant experience coming from a healthcare provider, payor, CBO, business office environment or an outsourcing company • Demonstrated experience overseeing payer enrollment across multiple provider organizations or departments (preferred) • Proficiency with enrollment and credentialing systems: MD-Staff – required for delegated enrollment and system customization • Symplr – preferred for systems support during UAB Medicine’s transition • Experience with billing systems and claim platforms: Athena One, IDX, and Epic – required for enrollment holds, denials, and billing readiness integration • Ability to lead and scale teams during organizational growth • Ability to align enrollment functions with Revenue Cycle strategy and planning • Ability to implement automation, reporting tools, and operational process improvements • Excellent communication and stakeholder management skills, including presenting to senior leadership and navigating cross-departmental alignment • Travel Required: Up to 25%

🏖️ Benefits

• Medical, Rx, Dental & Vision Insurance • Personal and Family Sick Time & Company Paid Holidays • Position may be eligible for a discretionary variable incentive bonus • Parental Leave • 401(k) Retirement Plan • Basic Life & Supplemental Life • Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts • Short-Term & Long-Term Disability • Tuition Reimbursement, Personal Development & Learning Opportunities • Skills Development & Certifications • Employee Referral Program • Corporate Sponsored Events & Community Outreach • Emergency Back-Up Childcare Program • Competitive compensation and a flexible benefits package