Walmart
(USA) Senior Manager, Enrollment Services
Walmart, Bentonville, Arkansas, United States, 72712
Senior Manager Enrollment Services
Are you a visionary leader with a passion for streamlining healthcare operations? Lead and transform our enrollment processes! As Senior Manager, you'll ensure seamless onboarding for providers, optimizing our network and enhancing patient care. Leading enrollment efforts with pharmacy clinical expansion Lead and oversee pharmacist provider enrollment in Medicaid and Medicare with growth of expanded clinical services and recognition of pharmacist's providers status by states and the federal government, ensuring compliance with regulatory requirements and internal policies. Participate in Stakeholder review of Payer contracts and Provider Manual reviews with internal stakeholders Develop and implement innovative strategies to streamline workflows, reduce processing times, and enhance the overall provider experience. This includes identifying and implementing technological solutions to improve efficiency. Analyze key performance indicators (KPIs) and enrollment data to identify trends, areas for improvement, and opportunities for process optimization. Collaborate effectively with cross-functional teams (IT, legal, compliance, operations, contracting) to improve systems, procedures, and communication related to provider enrollment. Mentor and develop a high-performing team of enrollment coordinators, fostering a culture of continuous improvement and excellence. About the team: Our Enrollment Services team is dedicated to ensuring that Providers and Facilities are efficiently and accurately enrolled in our network. We operate collaboratively, striving to support the company's mission of helping people save money and live better by ensuring accessible and high-quality healthcare services. Your leadership will be crucial in streamlining processes and improving provider satisfaction. What you'll bring: Commitment to maintaining the highest ethical standards and fostering a strong organizational structure that prioritizes efficiency, accuracy, and compliance. Exceptional organizational skills and attention to detail, ensuring efficient and accurate enrollment processes. Deep understanding of regulatory requirements and industry standards related to provider enrollment, including familiarity with various payer types (governmental and commercial). Expert analytical skills and the ability to translate data insights into actionable strategies for process improvement. Proven leadership and team management skills, with a demonstrated ability to build and motivate high-performing teams. Minimum Qualifications: Option 1: Bachelor's degree in healthcare administration, business, accounting, economics, or related area and 3 years' experience in revenue cycle management, billing, payer enrollment, or related area. Option 2: 5 years' experience in revenue cycle management, billing, payer enrollment, or related area. Prior work experience in eligibility and insurance verification processes, provider enrollment, and EDI practices. Prior work experience with enrolling providers and facilities in commercial and government plans across all 50 states. Prior work experience in NCQA, Joint Commission, URAC, CMS, and state laws and regulations involving provider credentials. Prior work experience in CAQH and credentialing processes. Preferred Qualifications: Master's degree in Healthcare Administration, Business, Accounting, Economics, or related area., NAMSS Credentialing/Enrollment Certification (CPCS, CPMSM). Primary Location: 2608 Se J St, Bentonville, AR 72712, United States of America
Are you a visionary leader with a passion for streamlining healthcare operations? Lead and transform our enrollment processes! As Senior Manager, you'll ensure seamless onboarding for providers, optimizing our network and enhancing patient care. Leading enrollment efforts with pharmacy clinical expansion Lead and oversee pharmacist provider enrollment in Medicaid and Medicare with growth of expanded clinical services and recognition of pharmacist's providers status by states and the federal government, ensuring compliance with regulatory requirements and internal policies. Participate in Stakeholder review of Payer contracts and Provider Manual reviews with internal stakeholders Develop and implement innovative strategies to streamline workflows, reduce processing times, and enhance the overall provider experience. This includes identifying and implementing technological solutions to improve efficiency. Analyze key performance indicators (KPIs) and enrollment data to identify trends, areas for improvement, and opportunities for process optimization. Collaborate effectively with cross-functional teams (IT, legal, compliance, operations, contracting) to improve systems, procedures, and communication related to provider enrollment. Mentor and develop a high-performing team of enrollment coordinators, fostering a culture of continuous improvement and excellence. About the team: Our Enrollment Services team is dedicated to ensuring that Providers and Facilities are efficiently and accurately enrolled in our network. We operate collaboratively, striving to support the company's mission of helping people save money and live better by ensuring accessible and high-quality healthcare services. Your leadership will be crucial in streamlining processes and improving provider satisfaction. What you'll bring: Commitment to maintaining the highest ethical standards and fostering a strong organizational structure that prioritizes efficiency, accuracy, and compliance. Exceptional organizational skills and attention to detail, ensuring efficient and accurate enrollment processes. Deep understanding of regulatory requirements and industry standards related to provider enrollment, including familiarity with various payer types (governmental and commercial). Expert analytical skills and the ability to translate data insights into actionable strategies for process improvement. Proven leadership and team management skills, with a demonstrated ability to build and motivate high-performing teams. Minimum Qualifications: Option 1: Bachelor's degree in healthcare administration, business, accounting, economics, or related area and 3 years' experience in revenue cycle management, billing, payer enrollment, or related area. Option 2: 5 years' experience in revenue cycle management, billing, payer enrollment, or related area. Prior work experience in eligibility and insurance verification processes, provider enrollment, and EDI practices. Prior work experience with enrolling providers and facilities in commercial and government plans across all 50 states. Prior work experience in NCQA, Joint Commission, URAC, CMS, and state laws and regulations involving provider credentials. Prior work experience in CAQH and credentialing processes. Preferred Qualifications: Master's degree in Healthcare Administration, Business, Accounting, Economics, or related area., NAMSS Credentialing/Enrollment Certification (CPCS, CPMSM). Primary Location: 2608 Se J St, Bentonville, AR 72712, United States of America