Director, Out of State Medicaid

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🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🔴 Lead

👔 Director

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EnableComp

WebsiteLinkedInAll Job Openings

501 - 1000 employees

💼 Consulting

🛡️ Insurance

📦 Logistics

💰 Venture Round on 2022-07

Consulting • Insurance • Logistics

EnableComp is a company that specializes in revenue cycle management (RCM) for healthcare providers and health systems across the United States. They focus on processing complex claims related to Veterans Administration, Workers' Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid, as well as denial management for all payer classes. By leveraging intelligent automation and their proprietary E360 RCM™ platform, EnableComp helps healthcare providers increase revenue, control costs, and streamline billing processes. With expertise in handling complex claims, the company ensures accurate and timely reimbursement, providing significant uplift to collections and improving the financial performance of its clients.

📋 Description

• Ensure processes and inventory support monthly, quarterly, and annual revenue expectations • Lead multiple teams through Managers and Supervisors, establishing operational and strategic goals • Oversee hiring, onboarding, performance management, workload distribution, and capacity planning • Conduct audits and client reviews to ensure requirements are met • Monitor key performance metrics and provide performance reporting with corrective action plans • Help set strategic direction and identify continuous improvement opportunities for the Out-of-State Medicaid team • Maintain knowledge of insurance billing and reimbursement procedures and regulations • Analyze collections system processes in Enforcer and recommend process and SOP improvements • Coordinate cross-functional resources to execute account action plans and resolve operational challenges • Oversee quality, productivity, workflow, service-level, and compliance standards, including HIPAA • Coach Managers and Supervisors and develop future leadership capability • Support operational and business transformation initiatives • Maximize efficiency through process analysis and interdepartmental collaboration

🎯 Requirements

• High School Diploma or GED required • Bachelor’s degree in business or healthcare administration preferred • 7–10 years of management or supervisory experience with teams of 10+ • 6+ years of experience in a healthcare setting, information technology company, or managed care industry • Preferably experience in Finance/Collections, Business Operations, or Revenue Recovery • Experience working with internal teams in a client-facing or client-support role • Knowledge of financials, HMOs, hospital revenue cycle processes, ancillary and provider contract language, and healthcare/provider data sets • Extensive understanding of insurance payer/provider claim processing and related data requirements • Strong computer proficiency and ability to use MS Office, including Word, Excel, and Outlook • Timely and regular attendance • Equivalent combination of education and experience will be considered • Strong professional written and oral communication skills • Experience in a production environment and ability to meet deadlines • Excellent people skills for interfacing with multiple internal stakeholders • Demonstrated collaborative teamwork and cross-functional work ability • Proven success obtaining quantifiable results from and setting priorities for direct reports • Organized, able to handle multiple projects simultaneously • Ability to set and manage multiple priorities across several teams • Experience communicating obstacles and challenges and developing action plans for management

🏖️ Benefits

• Professional growth and development • Tools, resources, and support for career growth • Flexible and family-oriented work environment • Work-life balance support • Top Workplaces-recognized employer