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Payer Enrollment Manager - Healthcare Revenue Cycle
Payer Enrollment Manager - Healthcare Revenue CycleGuidehouse Inc • Washington, DC, United States
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Payer Enrollment Manager - Healthcare Revenue Cycle

Payer Enrollment Manager - Healthcare Revenue Cycle

Guidehouse Inc • Washington, DC, United States
9 days ago
Job type
  • Full-time
Job description

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What You Will Do

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 projects and issues with the MDSO and Manage Care Contracting, and 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.

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, 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, CVO, 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

  • Bachelor's Degree with a minimum 7 years of prior relevant experience or Associate's Degree with a minimum 9 years of prior relevant experience (formally educated experience may substitute for advanced degree).
  • 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.
  • What We Offer

    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
  • About Guidehouse

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

    Seniority level

  • Mid‑Senior level
  • Employment type

  • Full‑time
  • Job function

  • Education and Training
  • Business Consulting and Services
  • 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.

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    Revenue Cycle Manager • Washington, DC, United States

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