We have an exciting Provider Enrollment Manager opportunity for an experienced leader with strong provider enrollment experience and strong working knowledge of Medicaid as well as CAQH standards to join our team. Pediatrix Medical Group is a physician lead organization, and we are one of the nation’s largest providers of prenatal, neonatal and pediatric services.

Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere.  We offer a diverse range of opportunities, competitive salaries and benefits, and a commitment to clinical excellence, we are confident that you'll love being a part of the Pediatrix team. 

The Provider Enrollment Manager is responsible for managing the CBO activities of the Region to ensure effective operations, compliance with government/state regulations, and that all Pediatrix physicians, nurse practitioners, physician assistants and certified nurse midwives are appropriately credentialed with licensing agencies, hospitals, and health plans. 

• Manage enrollment activities to ensure accurate and timely enrollment of our providers on appropriate health plans
• Manage acquisitions as related to gathering of appropriate provider data and documents and all credentialing and enrollment
• Coordinate assignments, work flow and establishes priorities on a daily basis for employees
• Monitors data collection process and analyzes information received for physicians and nurse files
• Develop and maintain all policies and procedures for department processes and revise as needed
• Develop reports to various department managers and staff to discuss issues, obtain feedback and disseminate information regarding credentialing issues
• Coordinate and participate in the “delegated credentialing” process with managed care companies, including annual audits
• Plan, prepare and implement department budget
• Interview prospective employees, coordinate orientation, manage employee performance, counsel employee and implement corrective action, schedule staff and time off
• Evaluate and perform annual performance appraisal for each employee
• Manage process of establishing timelines for office-based practices and participate in meetings with managers of these practices
• Communicate with Information Management, Managed Care, and Risk Management as it related to all license, privilege, and health plan enrollment issues, including malpractice insurance, provider group/pin numbers, and new health plan contracts 

Education/Experience:

• Bachelor’s Degree required. 
• 4 years provider enrollment experience required
• Minimum 2 years management experience required.
• Knowledge of credentialing standards, which includes state and federal regulations as well as hospital regulations and NCQA standards required. 

Benefits for Full Time employees and qualified dependents: 

• Medical, Prescription, Dental, Vision Insurance
• Progyny Fertility Benefits
• Livongo Diabetes Management
• Teladoc Health and Second Opinion Services
• Smart Shopper
• 401(K) Thrift Program & Sharing Plan**
• Employee Stock Purchase Plan (ESPP) – 15% discount*
• Basic Employee; Spouse; Child Life Insurance
• Accidental Death and Dismemberment (AD&D)
• Employee Optional Life and AD&D
• Short & Long Term Disability
• Pre-Tax Health Savings Accounts (HSA)
• Employee and Dependent Flexible Spending Account (FSA)
• Family Medical Leave Act (FMLA)**
• Parental Leave Benefit
• Sick Pay Bank
• Employee Assistance Program (EAP)**
• Group Aflac Policies
• Identity Theft Protection
• Employee Charitable Fund
• Care.com
• Various Discount Programs

*Part Time Regular employee classifications also receive this benefit

**Available to part-time regular and part-time casual employees aged 21 and over

Pediatrix Medical Group is one of the nation’s leading providers of highly specialized health care for women, babies and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate and clinically excellent services to women, babies and children across the continuum of care, both in hospital settings and office-based practices. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement and safety initiatives. 

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.

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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.