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Credentialing & Payor Enrollment Supervisor at Ensemble… · 2…
Job Description
Credentialing & Payor Enrollment Supervisor
Location: Remote - Nationwide
Thank you for considering a career at Ensemble!
Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!
O.N.E Purpose:
Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.
Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.
Striving for Excellence: Execute at a high level by demonstrating our “Best in KLAS” Ensemble Difference Principles and consistently delivering outstanding results.
The Opportunity:
CAREER OPPORTUNITY OFFERING:
Bonus Incentives
Paid Certifications
Tuition Reimbursement
Comprehensive Benefits
Career Advancement
This pay range for this position is $69,400.00-$104,100.00 annually depending on experience.
The Credentialing & Payor Enrollment Supervisor leads daily credentialing and payor enrollment operations to support timely provider readiness, payer participation, and compliance with applicable regulatory, accreditation, payer, and internal requirements. This role supervises credentialing specialists, monitors operational performance, ensures accurate provider data and documentation, and supports completion of credentialing, recredentialing, enrollment, revalidation, maintenance, delegated roster, and related payer activities. The Supervisor serves as an escalation point for complex or high-risk items and supports continuous improvement of quality, timeliness, and audit readiness across the function.
The Credentialing & Payor Enrollment Supervisor oversees execution of credentialing and payor enrollment activities across provider, group, and facility workflows. This role manages work queues and operational priorities, supervises team performance, monitors quality and compliance standards, and collaborates with internal stakeholders, clients, and payer representatives to ensure accurate and timely credentialing and enrollment outcomes. The Supervisor promotes process consistency, maintains audit-ready documentation, and ensures adherence to regulatory, accreditation, payer, delegated credentialing, and internal policy requirements.
Key Responsibilities
- Supervise daily provider credentialing and payor enrollment operations and workflow activities.
- Lead and develop Provider Credentialing Specialists through coaching, training, performance management, and workload coordination.
- Oversee credentialing, recredentialing, initial enrollment, revalidation, maintenance, termination, group enrollment, facility enrollment, and ownership change activities.
- Monitor credentialing and enrollment status, aging reports, work queues, payer follow-up, and application progress to support timely completion of requirements.
- Investigate and resolve complex credentialing, enrollment, payer, data, documentation, and operational escalations.
- Ensure accurate maintenance of provider credentialing and enrollment information within designated systems and databases.
- Coordinate credentialing and enrollment activities with medical staff, revenue cycle, operations, clients, payer representatives, and other cross-functional partners.
- Ensure compliance with payer requirements, CMS guidelines, NCQA standards, delegated credentialing requirements, applicable regulations, and internal policies.
- Maintain complete, accurate, and audit-ready documentation for credentialing and enrollment activities.
- Perform quality reviews and routine audits to promote accuracy, consistency, compliance, and process improvement.
- Support delegated roster submission, receipt confirmation, payer approval follow-up, and related documentation requirements.
- Analyze operational performance metrics and identify opportunities to improve efficiency, quality, service delivery, and provider readiness outcomes.
- Support implementation of standard work procedures, process improvements, quality controls, and best practices.
- Maintain awareness of regulatory, accreditation, payer, and industry changes impacting provider credentialing and payor enrollment operations.
- Prepare reporting and status updates for leadership regarding operational performance, credentialing and enrollment progress, risks, and escalations.
Knowledge, Skills & Abilities
- Provider credentialing, recredentialing, payor enrollment, and provider lifecycle processes.
- Governmental and commercial payer requirements related to provider participation and enrollment.
- Healthcare regulatory, accreditation, and delegated credentialing requirements affecting credentialing and enrollment operations.
- Provider data management, credentialing, enrollment, and documentation
- Delegated credentialing, payer roster, provider group, and facility enrollment processes.
- Operational performance measurement, quality assurance, audit readiness, and compliance control methodologies.
Skills
- Team leadership, coaching, and employee development.
- Workflow coordination and operational process management.
- Issue resolution, risk identification, and escalation management.
- Data analysis, reporting, and operational monitoring.
- Quality assurance, documentation review, and audit support.
- Cross-functional communication, stakeholder coordination, and follow-through.
Abilities
- Prioritize multiple operational demands in a fast-paced and deadline-driven environment.
- Interpret complex payer, regulatory, accreditation, and delegated credentialing requirements.
- Build effective relationships with internal teams, clients, providers, and payer representatives.
- Communicate clearly across varying organizational levels and functional areas
- Identify operational risks and support corrective action or process improvement plans.
- Drive accountability for quality, compliance, timeliness, audit readiness, and service performance.
- Demonstrated advanced usage of AI and the management of teams using AI to lean in to process and technological improvements, to include the exploration, experimentation, and application of AI.
- This is a remote position; however, candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require
Required Qualifications
- Bachelor's degree in Healthcare Administration, Business Administration, Revenue Cycle Management, or related field; equivalent combination of education and experience may be considered.
- Minimum 5 years of provider credentialing, payor enrollment, or closely related healthcare operations experience.
- Minimum 2 years of direct leadership, supervisory, or team lead experience.
- Experience working with commercial and governmental payer credentialing or enrollment processes.
- Experience utilizing provider credentialing, enrollment, or provider data management systems.
- Demonstrated knowledge of healthcare regulatory, accreditation, payer, or delegated credentialing requirements impacting provider credentialing and enrollment operations.
Preferred Qualifications
- Experience supporting delegated credentialing environments.
- Experience working with NCQA standards and accreditation requirements.
- Experience supporting multi-state provider, group, or facility credentialing and payor enrollment activities.
- Experience leading credentialing or payor enrollment operations within a centralized shared services environment.
- Professional certification related to credentialing, provider enrollment, healthcare operations, or revenue cycle management.
#LI-LG1
Join an award-winning company
Five-time winner of “Best in KLAS” 2020-2022, 2024-2025
Black Book Research's Top Revenue Cycle Management Outsourcing Solution 2021-2024
22 Healthcare Financial Management Association (HFMA) MAP Awards for High Performance in Revenue Cycle 2019-2024
Leader in Everest Group's RCM Operations PEAK Matrix Assessment 2024
Clarivate Healthcare Business Insights (HBI) Revenue Cycle Awards for strong performance 2020, 2022-2023
Energage Top Workplaces USA 2022-2024
Fortune Media Best Workplaces in Healthcare 2024
Monster Top Workplace for Remote Work 2024
Great Place to Work certified 2023-2024
- Innovation
- Work-Life Flexibility
- Leadership
- Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
- Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
- Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
- Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
- Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble also prohibits harassment of applicants or employees based on any of these protected categories.
Due to business, operational, payroll, and regulatory requirements, this position is limited to individuals who reside and are authorized to work within the United States. Applications generated from outside the United States will not be considered. Individuals may reapply when located within the United States.
Ensemble provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact TA@ensemblehp.com.
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.