Payer Enrollment Manager - Healthcare Revenue Cycle

Payer Enrollment Manager

The Payer Enrollment Manager is responsible for leading and overseeing payer enrollment operations across UAB Medicine, UAB St. Vincent's, and a growing number of affiliated entities. This position manages both delegated and direct enrollment functions, payer relationships, system integrity, coordination of project and issues with the MDSO and Manage Care Contracting as well as staff performance across multiple teams. The role serves as the primary operational and strategic leader ensuring efficient and compliant enrollment of providers with government and commercial payers.

This position plays a critical role in partnering with Revenue Cycle leadership, contracting, and credentialing teams to align enrollment efforts with broader organizational priorities. By serving as the key representative in planning meetings, payer strategy sessions, and system initiatives, the Manager enables the Enrollment Supervisor and team to focus more fully on day-to-day operational tasks and provider support.

Leadership & Team Oversight :

Directly manages the MSO Enrollment team (UAB Medicine) and Payer Enrollment staff supporting UAB St. Vincent's and multiple affiliated organizations.

Supervises Enrollment Leads and the MSO Enrollment Supervisor; provides coaching, mentorship, work prioritization, and performance management.

Oversees staffing models and resource allocation to meet the enrollment needs of a growing number of supported entities.

Establishes structure and accountability that allows supervisory-level staff to focus on detailed enrollment processing and team development.

Operational Management :

Manages all delegated roster submissions and direct enrollment workflows across supported organizations, ensuring timely and accurate processing.

Oversees recredentialing, demographic updates, and compliance-driven enrollment maintenance tasks.

Serves as the primary operational escalation point for issues impacting provider setup, billing delays, or denials related to enrollment.

System Stewardship :

Leads system oversight and optimization for MD-Staff (currently in use at St. Vincent's and transitioning to UAB Medicine), including workflow configuration, reporting, data quality, and roster tracking.

Ensures continuity of Symplr usage at UAB Medicine during the transition to MD-Staff.

Partners with system teams to align Athena One, IDX, and Epic for billing readiness, enrollment holds, and denial resolution related to provider setup and participation status.

Revenue Cycle Collaboration :

Represents the enrollment function in Revenue Cycle leadership meetings, planning discussions, and payer operations workgroups.

Partners with AR follow-up and billing teams to identify and resolve payer enrollment-related denials, edits, or claim holds.

Ensures payer setup and provider linkage processes are optimized to support clean claims and timely reimbursement.

Collaborates with the MDSO team (UAB Medicine), CVO (St. Vincent's), Managed Care Contracting and other stakeholders to ensure process alignment and accountability.

Process Improvement & Governance :

Develops, maintains, and enforces standard operating procedures for all payer enrollment functions.

Identifies opportunities for automation, reporting, and workflow redesign to improve efficiency and compliance.

Tracks KPIs and prepares reports for leadership on enrollment status, backlog, processing timelines, and issue resolution trends.

Compliance & Delegation Oversight :

Ensures all delegated enrollment activities meet contractual obligations and are audit ready.

Maintains awareness of payer-specific policies and proactively adapts workflows to remain in compliance.

What You Will Need :

Requires a Bachelor's Degree and a minimum 7 years of prior relevant experience or Associate's Degree and a minimum 9 years of prior relevant experience.

At least three (3) years in payer enrollment, credentialing, or managed care operations.

Relevant experience coming from a healthcare provider, payor, CBO, business office environment or an outsourcing company.

What Would Be Nice To Have :

Master's degree (MBA, MHA, MPA) preferred.

Demonstrated experience overseeing payer enrollment across multiple provider organizations or departments.

Proficiency with enrollment and credentialing systems :

MD-Staff required for delegated enrollment and system customization.

Symplr preferred for systems support during UAB Medicine's transition.

Experience with billing systems and claim platforms :

Athena One, IDX, and Epic required for enrollment holds, denials, and billing readiness integration.

Ability to :

Lead and scale teams during organizational growth.

Align enrollment functions with Revenue Cycle strategy and planning.

Implement automation, reporting tools, and operational process improvements.

Excellent communication and stakeholder management skills, including presenting to senior leadership and navigating cross-departmental alignment.

The annual salary range for this position is $77,000.00-$129,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include :

Medical, Rx, Dental & Vision Insurance

Personal and Family Sick Time & Company Paid Holidays

Position may be eligible for a discretionary variable incentive bonus

Parental Leave

401(k) Retirement Plan

Basic Life & Supplemental Life

Health Savings Account, Dental / Vision & Dependent Care Flexible Spending Accounts

Short-Term & Long-Term Disability

Tuition Reimbursement, Personal Development & Learning Opportunities

Skills Development & Certifications

Employee Referral Program

Corporate Sponsored Events & Community Outreach

Emergency Back-Up Childcare Program

Guidehouse is an Equal Opportunity EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

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