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Provider Enrollment Specialist
Ref No.: 18-07478
Location: Boston, Massachusetts
Provider Enrollment Specialist
Need a candidate with direct credentialing or provider enrollment experience, the volume and high expectations would not be suitable for entry level candidates
Site Location: 89 A Street, Needham MA 02494
Department: Provider Enrollment
Duration: Temp to perm
Schedule: M-F (1st shift)

Job Description:
Coordinates all operational aspects of enrolling SHCN physicians into SHCN-contracted managed care health plans working closely with other SHCN Managers, SHCN Provider Enrollment, and network representatives. Specifically, the Provider Enrollment Liaison is responsible to Coordinate the full cycle Provider Enrollment function for SHCN, across the entire physician network. Develop close and collaborative working relationships with provider and PO offices to streamline the accurate submission of information to the health plans and to SHCN. Conducts ongoing audit of the process to ensure accuracy of provider data. Identifies opportunities for improvements in the process and develops strategies to implement appropriate changes/enhancements. Develop partnerships with relevant staff at the health plans in coordinating enrollment of SHCN providers.

Special Skills/Experience Required:
Reporting to the Provider Relations Manager, the Provider Enrollment Liaison coordinates the accurate and efficient enrollment of SHCN providers into health plan contracts.
I. Education: Associates degree in a related field (or equivalent combination of education and experience).
II. Experience (Type & Length): Three to five years administrative experience, preferably within a healthcare environment.
III. Software/Hardware: Familiarity with Microsoft Office software (Word, Access, Excel, PowerPoint)