Payer Enrollment Manager

Overview

The Credentialing Department is responsible for verifying the qualifications of dental providers and ensuring they are properly enrolled to participate in insurance networks and government programs. The department manages the entire credentialing lifecycle, working closely with insurance organizations and internal teams to maintain accurate provider data, resolve discrepancies, and ensure that provider profiles remain up to date. Additionally, the department fosters strong relationships with dental practices, insurance providers, and internal stakeholders. A key focus is driving ongoing process improvements and efficiencies to promote seamless collaboration and increase productivity across teams.

Job Summary:

The Payer Enrollment Manager is responsible for overseeing all provider enrollment operations, ensuring timely application submission and compliance of processes. This role plays a critical part in managing key relationships with payers, driving continuous process improvement, and facilitating clear communication to ensure excellence in service delivery. The Payer Enrollment Manager will collaborate with Delegated Credentialing, Data Services, Quality Assurance, Payer Strategy, and internal stakeholders to support the optimization of credentialing functions.

Key Responsibilities:

• Provide leadership to the Payer Enrollment Team, including coaching, development, workload allocation, and performance management
• Own the end to end process of provider and group enrollment for commercial and government payers
• Act as a liaison between providers and payer organizations, resolving any issues or delays in the enrollment process
• Track and manage all payer enrollment as new payor contracts are added and expand to new states
• Monitor and update credentialing information in platform to reflect status and changes in enrollment
• Deliver concise and timely updates to Operations Teams regarding the progress of enrollment applications and payer approvals
• Maintain up-to-date knowledge of payer and regulatory requirements and dental industry best practices
• Strong enrollment expertise with a track record of optimizing workflows, implementing scalable solutions, and improving efficiency
• Foster a culture of accountability, operational excellence, and continuous improvement
• Support and refine reporting, dashboards, and analytics to track enrollment timelines and team productivity
• Collaborate with Quality Assurance leader to ensure delivery on established quality metrics
• Collaborate with leadership to identify opportunities for automation or optimization
• Proven ability to manage and develop a high-performing team, with a focus on coaching, mentoring, and professional growth
• Assist and support leadership with various strategic projects

Required Qualifications:

• Minimum 3 – 5 years management experience
• Minimum 3 – 5 years payer enrollment experience
• Strong capability to collaborate and communicate
• Positive attitude
• Detail-oriented with a focus on accuracy

Desired Qualifications:

• Certifications: CPES is a plus

We are an equal opportunity employer.

INDHRM200