Description

This position is incentive eligible.

Introduction

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Managed Care Payer Enrollment Director with Parallon, you can be a part of an organization that is devoted to giving back!

Benefits

Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

• Free counseling services and resources for emotional, physical and financial wellbeing

• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

• Employee Stock Purchase Plan with 10% off HCA Healthcare stock

• Family support through fertility and family building benefits with Progyny and adoption assistance.

• Referral services for child, elder and pet care, home and auto repair, event planning and more

• Consumer discounts through Abenity and Consumer Discounts

• Retirement readiness, rollover assistance services and preferred banking partnerships

• Education assistance (tuition, student loan, certification support, dependent scholarships)

• Colleague recognition program

• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

Note: Eligibility for benefits may vary by location.

Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Parallon family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Managed Care Payer Enrollment Director to help us reach our goals. Unlock your potential!

Job Summary and Qualifications

As the Director of Managed Care Payer Enrollment, you are responsible for leading the strategic and operational aspects of payer enrollment and re-enrollment processes. This role combines high-level oversight with hands-on engagement, ensuring compliance, team efficiency, and exceptional client outcomes. You will be accountable for providing a timely, effective, thorough, and accurate enrollment process for initial enrollments and re-enrollments for select HCA hospitals within established service levels.

In this role, you will:

• Lead the strategic planning and execution of payer enrollment and re-enrollment processes to align with organizational objectives.

• Manage day-to-day operations to ensure efficiency, accuracy, and compliance with policies and regulations.

• Supervise, mentor, and motivate the enrollment team to achieve high performance standards and departmental goals.

• Ensure all enrollment activities comply with relevant federal, state, and organizational regulations and policies.

• Continuously evaluate and enhance enrollment processes to improve efficiency and accuracy.

• Maintain exceptional client outcomes by ensuring the timely and accurate completion of enrollment processes for initial and re-enrollments.

• Collaborate with hospital leadership, regulatory bodies, and other stakeholders to align enrollment processes with organizational goals and standards.

• Provide regular reports on enrollment activities, performance metrics, and improvement opportunities to senior management.

• Ensure the fiscal responsibility of the Managed Care Payer Enrollment Credentialing Processing Center (CPC) by managing the creation and administration of budgets, as well as overseeing accounts receivable for application processing fees.

What qualifications you will need:

• BA/BS degree required

• At least 3-5 years of operations management or management experience within Parallon required, or 5 years of experience in a centralized credentialing/primary source verification office, managed care experience preferred.

• Experience with Managed Care Credentialing or National Committee for Quality Assurance preferred.

• Comprehensive working knowledge of the healthcare, payer enrollment, credentialing industry, including medical-legal issues, laws, regulatory agencies, and national standards preferred.

• Certified Specialist Managed Care (CSMC) or NAMSS Certification, preferred

" Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses."

"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

Be a part of an organization that invests in you! We are reviewing applications for our Credentialing Director opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.