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Ensemble Health Partners

End-to-end revenue cycle management for hospitals

Credentialing & Payor Enrollment Supervisor

Clerical & Data EntryConfirmed live in the last 24 hours
Full-time

About the Job

Requirements

  • A bachelor's degree in Healthcare Administration, Business Administration, Revenue Cycle Management, or a related field is required; an equivalent combination of education and experience may be considered.
  • At least 5 years of provider credentialing, payor enrollment, or closely related healthcare operations experience is required.
  • At least 2 years of direct leadership, supervisory, or team lead experience is required.
  • Experience with commercial and governmental payer credentialing or enrollment processes is required.
  • Experience using provider credentialing, enrollment, or provider data management systems is required.
  • Knowledge of healthcare regulatory, accreditation, payer, or delegated credentialing requirements affecting provider credentialing and enrollment operations is required.
  • Candidates must reside in and be authorized to work within the United States.
  • Candidates must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
  • Knowledge of provider credentialing, recredentialing, payor enrollment, and provider lifecycle processes is required.
  • Knowledge of governmental and commercial payer requirements related to provider participation and enrollment is required.
  • Knowledge of healthcare regulatory, accreditation, and delegated credentialing requirements affecting credentialing and enrollment operations is required.
  • Knowledge of provider data management, credentialing, enrollment, and documentation is required.
  • Knowledge of delegated credentialing, payer roster, provider group, and facility enrollment processes is required.
  • Knowledge of operational performance measurement, quality assurance, audit readiness, and compliance control methodologies is required.
  • Skills in team leadership, coaching, and employee development are required.
  • Skills in workflow coordination and operational process management are required.
  • Skills in issue resolution, risk identification, and escalation management are required.
  • Skills in data analysis, reporting, and operational monitoring are required.
  • Skills in quality assurance, documentation review, and audit support are required.
  • Skills in cross-functional communication, stakeholder coordination, and follow-through are required.
  • Ability to prioritize multiple operational demands in a fast-paced, deadline-driven environment is required.
  • Ability to interpret complex payer, regulatory, accreditation, and delegated credentialing requirements is required.
  • Ability to build effective relationships with internal teams, clients, providers, and payer representatives is required.
  • Ability to communicate clearly across organizational levels and functional areas is required.
  • Ability to identify operational risks and support corrective action or process improvement plans is required.
  • Ability to drive accountability for quality, compliance, timeliness, audit readiness, and service performance is required.
  • Demonstrated advanced use of artificial intelligence and management of teams using artificial intelligence to support process and technological improvements, including exploration, experimentation, and application, is required.

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, Centers for Medicare & Medicaid Services guidelines, National Committee for Quality Assurance 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.

Desired Qualifications

  • Experience supporting delegated credentialing environments is preferred.
  • Experience working with National Committee for Quality Assurance standards and accreditation requirements is preferred.
  • Experience supporting multi-state provider, group, or facility credentialing and payor enrollment activities is preferred.
  • Experience leading credentialing or payor enrollment operations within a centralized shared services environment is preferred.
  • A professional certification related to credentialing, provider enrollment, healthcare operations, or revenue cycle management is preferred.

About the Company

Ensemble Health Partners

End-to-end revenue cycle management for hospitals

Ensemble Health Partners provides end-to-end revenue cycle management for hospitals and health systems. It handles the entire process from patient intake to final payment, with teams and technology embedded into the provider's operations and a revenue model tied to performance improvements. The company uses its proprietary EIQ platform (analytics, AI, and workflow automation) to optimize revenue cycle processes, reduce insurance denials, and speed cash collection, managing more than $39 billion in net patient revenue. Its approach differentiates it by being a true managed-services partner with full accountability for financial outcomes and a track record of meeting initial client goals. The overarching goal is to improve healthcare providers’ financial performance so they can focus on patient care.

Company size
5,001-10,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Cincinnati, OH
Founded
2014

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