Vice President, Provider Enrollment
Description
At SCP Health, what you do matters
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
As part of the SCP Health team, you have an opportunity to make a difference. At our core, we work to bring hospitals and healers together in the pursuit of clinical effectiveness. With a portfolio of over 8 million patients, 7500 providers, 30 states, and 400 healthcare facilities, SCP Health is a leader in clinical practice management spanning the entire continuum of care, including emergency medicine, hospital medicine, wellness, telemedicine, intensive care, and ambulatory care.
Why you will love working here:
- Flexible schedules and work-from-home opportunities
- Strong track record of providing excellent work/life balance
- Comprehensive benefits package and competitive compensation
- Commitment to fostering an inclusive culture of belonging and empowerment through our core values - collaboration, courage, agility, and respect.
What you’ll be doing:
The Vice President, Provider Enrollment provides strategic, integrated, and consultative support to assure provider enrollment activities occur timely and accurately with primary Commercial, Federal, and State payer programs. This is a critical leadership role established to drive clinician onboarding processes, develop practice policies, and preserve revenue associated with new client-contract starts and in conjunction with organizational strategies. The leader must possess the ability to understand business strategies and align resources successfully to achieve SCP Health’s business goals and objectives.
The VP, Provider Enrollment must partner with all stakeholders and be able to influence and gain the respect and trust of their staff, peers, Revenue Cycle Services leaders, Medical Staff Operations, and the Executive Finance Team. Success in this position relies on the capacity to build effective teams, drive change, and foster a team approach for problem solving and collaboration across the enterprise. The role combines people, process, and technology proficiency, as well as business acumen to appropriately evaluate and resolve complex provider concerns, payer enrollment procedures and regulations in payer enrollment compliance.
- Maintain compliance with all payer programs and procedures.
- Provide vision and planning to establish department policies and procedures consistent with organizational goals and objectives.
- Provide leadership and oversight to the Provider Enrollment Team and serves as a Subject Matter Expert (SME) to leadership and other departments in the organization.
- Develop and implement key performance indicator reporting to assess the productivity, accuracy, and effectiveness of the Provider Enrollment team’s performance.
- Provides oversight and approval of the quality of work produced by the Provider Enrollment team to ensure process and procedure execution.
- Plan, establish and maintain departmental budget in conjunction with RCS annual budgeting process.
- Work to meet monthly productivity goals and expectations.
- Management of the Provider Enrollment team to include staff productivity, hours worked, and team responsibilities to deliver all enrollment services timely for all SCP provider groups.
- Collaborate with HR/Recruiting to execute on hiring strategies to source, hire, train, coach, and mentor inexperienced staff to build a high-performing team.
- Seek out innovation and technology to leverage systems and process efficiency to positively impact production, quality, and customer satisfaction.
- Responsible for the oversight of key vendor-contract provisions for strategic partners and system resources.
- Ensures new provider startups and related revenue are reported on timely to senior leaders in Revenue Cycle Services, Finance and Accounting.
- Participate in leadership meetings related to new service lines, strategic accounts, legal-entity and system set-up, provider information set-up, as well as business development concerns related to onboarding new groups. Requires effective communication skills across multiple disciplines regarding Provider Enrollment concerns.
- Requires strategic approach to planning and disseminating team assignments. Drives quality and mindfulness for all work products and deliverables for Provider Enrollment.
- Maintains and manages compliance for payer guidelines and requirements.
- Assures oversight for strategic training plan for all Provider Enrollment leaders and staff.
- Strategic leader who directs the execution of large-scale implementations requiring project- management principles and techniques for tracking progress, and timely follow up to ensure project completion.
- Has oversight and quality assurance for active provider credential-profiles utilizing an enrollment database as required. Experience with HealthStream/Credential Stream or similar system is preferrable.
- Collaborates with the IT to provide input on system tools and resources affecting systems and data management concerns across the enterprise.
- Seeks continual process improvements and recommends enhancements in technology, processes, and staff engagement.
- Interprets complex payer rules, regulations and reports federal and state regulations pertaining to provider enrollment to clients.
- Must collaborate with the IT and Data Systems Management departments to maintain security compliance, program integrity, and system upgrades.
- Collaborates with SCP Health Managed Care Contracting to support the enrollment or delegated credentialing needs to establish and maintain new payer contracts.
- Collaborates with Provider Advocacy Leadership to positively impact lobbying process regarding provider enrollment issues.
- Resolves high level provider enrollment issues with payers by communicating concerns appropriately through our Managed Care Team.
- Maintains an annual operating budget of approximately $2M and related staffing for the Provider Enrollment Team. Sets goals and work standards for Provider Enrollment to deliver Active Provider reporting and track application submissions, re-validations and re-enrollment for all providers and groups as needed.
- Responsible for the oversight of key vendor-contract provisions for strategic partners and system resources.
- Adheres to all company policies and procedures.
Who/What we are looking for:
- Bachelor's degree or equivalent in Business Administration, Healthcare Administration, or related field
- Master's degree preferred.
- 8+ years’ experience leading Provider Enrollment or Medical Staff Services teams and/or department.
- Broad business acumen and leadership knowledge with a strong ability to influence.
- Ability to thrive in complex environments and manage and bring clarity to ambiguous situations.
- Understands financial modeling, general negotiating, contract management, and other practice management processes.
- Seen as a strong and effective leader.
- Highly efficient, collaborative, and organized.
- Executive presence with effective communication and oral presentation skills.
- Highly refined and effective relationship building skills.
- Excellent critical thinking and emotional intelligence capabilities.
- Consistently accountable, responsible, and available.
To learn more about SCP Health, please visit:
www.scphealth.com
www.scphealth.com
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SCP Health is an Equal Opportunity Employer.
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