Director Of Managed Care Enrollment Services

Job Description:

Job Title: Director of Managed Care Enrollment Services

Location: Missouri: Springfield, St. Louis, Columbia, Kansas City, Kirksville; Illinois: Quincy; Oklahoma: Tulsa (Remote/Hybrid Options Available)

Department: Managed Care

Employment Type: Full-Time

Shift: Mon-Fri 8am-5pm

Job Summary:

Are you a passionate and dedicated healthcare leader looking to make a positive impact in the managed care enrollment services of our organization? Do you want to work in a supportive and dynamic environment where you can grow your leadership skills and advance your career? Join our team as the Director of Managed Care Enrollment Services!

As the Director of Managed Care Enrollment Services, you'll oversee and lead all Managed Care Enrollment initiatives, processes, and procedures. You'll supervise the enrollment team, foster team member development, ensure policy integrity, identify improvement opportunities, and implement innovative practices based on industry standards. Our ideal candidate is passionate about healthcare enrollment services, has proven leadership experience, and strong communication and collaboration skills.

Position Perks & Benefits:

• Employee benefits package - health, dental, vision, retirement, life, & more

• Paid time off - 29 days per year including vacation & holiday pay

• Mileage reimbursement - company paid for work functions requiring travel

• Top-notch training - initial, ongoing, comprehensive, and supportive

• Career mobility - advancement opportunities/promoting from within

• Welcoming, warm, supportive - a work culture & environment that promotes your well-being, values you as human being, and encourages your health and happiness

Key Responsibilities:

• Supervise and develop Enrollment leaders.

• Lead initiatives to achieve department key performance indicators (KPIs), drive innovations, and enhance efficiencies in enrollments and data coordination through industry best practices.

• Maintain expertise in industry regulations (NCQA, URAC, State, Federal/CMS) and serve as the organization's regulatory subject matter expert.

• Manage all external organizational and individual enrollment records with Medicare, Medicaid, and commercial payers to ensure timely processing.

• Coordinate data between internal and external systems, including licensures, CAQH, and NPPES.

• Proactively identify and resolve issues, coordinate resolutions, and identify educational opportunities.

• Assist in administering the credentialing and enrollments database, ensuring compliance and accurate data communication.

• Develop and nurture collaborative relationships with external customers and internal leaders.

• Create and maintain enrollment dashboards to support team initiatives and stakeholder communication.

• Manage general department administration, including budget planning, regulatory compliance, and promoting organizational culture.

• Perform other duties as assigned.

Education and/or Experience Qualifications:

• Bachelor's degree in medical management, business administration, health administration, or equivalent professional experience strongly preferred.

• Minimum of five years' experience in Healthcare Administration Leadership, with preference given to those with experience in Revenue Cycle Leadership or Credentialing/Medical Team Leadership.

• Proficiency in Microsoft Office suite, particularly Excel, within a corporate office setting in the healthcare industry.

Additional Qualifications:

• Team player with exceptional interpersonal and communication skills, adept at building collaborative relationships with various stakeholders.

• Proven ability to motivate, lead, and influence others to implement operational improvements effectively.

• Advanced problem-solving capabilities, including strategic analysis and research to support decision-making.

• Proficiency in advanced computer skills for meaningful data presentation.

• Strong communication and interpersonal skills for interaction with senior leaders, physicians, peers, and team members.

• Leadership skills encompassing prioritization, organization, adaptability, goal setting, project leadership, and achieving results in a fast-paced environment.

• Demonstrated independence in decision-making, autonomy, and flexibility.

• Self-motivated with the ability to judge, prioritize, and accomplish major job duties effectively.

Supervisory Requirements:

• Communicate the strategic direction of the organization and encourage participation by all employees.

• Provide leadership and guidance to all aspects of the department.

• Take an active role in monitoring the identification, development, and execution of strategic objectives.

• Involve, as appropriate, all employees in order to achieve goals.

• Effectively communicate to employees any changes and newsworthy events within the department or company.

• Handle difficult employee situations directly, using appropriate discretion and Human Resource advice to show respect for the individual.

• Champion change and effectively manage the implementation of new ideas.

• Reinforce a team approach throughout functions; support and solicit input from team members at all levels within the company.

• Maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.

Brightli is on a Mission:

A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.

As a behavioral and community mental health provider, we value diversity, equity, and inclusion in our workforce and encourage applications from individuals from diverse backgrounds and experiences. If you are passionate about empowering your local communities and promoting health equity, we invite you to join our mission-driven organization that is committed to building a diverse, equitable, inclusive and authentic workplace.

We are an Equal Opportunity and Affirmative Action Employer, and encourage applications from all qualified individuals without regard to race, color, religion, sex, gender identity, gender expression, sexual orientation, national origin, age, marital status, disability or veteran status, or to other non-work related factors.

Burrell is a Smoke and Tobacco Free Workplace.