Payer Enrollment Manager - Healthcare Revenue Cycle

Payer Enrollment Manager

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

Responsibilities

• Lead and oversee payer enrollment operations across UAB Medicine, UAB St. Vincent’s, and affiliated entities.
• Directly manage the MSO Enrollment team (UAB Medicine) and Payer Enrollment staff supporting UAB St. Vincent’s and multiple affiliated organizations.
• Supervise Enrollment Leads and the MSO Enrollment Supervisor; provide coaching, mentorship, work prioritization, and performance management.
• Oversee staffing models and resource allocation to meet the enrollment needs of a growing number of supported entities.
• Establish structure and accountability that allows supervisory-level staff to focus on detailed enrollment processing and team development.
• Manage all delegated roster submissions and direct enrollment workflows across supported organizations, ensuring timely and accurate processing.
• Oversee recredentialing, demographic updates, and compliance-driven enrollment maintenance tasks.
• Serve as the primary operational escalation point for issues impacting provider setup, billing delays, or denials related to enrollment.
• Lead system oversight and optimization for MD-Staff and Symplr, manage workflow configuration, reporting, data quality, and roster tracking.
• Ensure continuity of Symplr usage at UAB Medicine during the transition to MD-Staff.
• Partner 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.
• Represent enrollment function in Revenue Cycle leadership meetings, planning discussions, and payer operations workgroups.
• Partner with AR follow-up and billing teams to identify and resolve payer enrollment-related denials, edits, or claim holds.
• Ensure payer setup and provider linkage processes are optimized to support clean claims and timely reimbursement.
• Collaborate with MDSO team (UAB Medicine), CVO (St. Vincent’s), Managed Care Contracting and other stakeholders to ensure process alignment and accountability.
• Develop, maintain, and enforce standard operating procedures for all payer enrollment functions.
• Identify opportunities for automation, reporting, and workflow redesign to improve efficiency and compliance.
• Track KPIs and prepare reports for leadership on enrollment status, backlog, processing timelines, and issue resolution trends.
• Ensure all delegated enrollment activities meet contractual obligations and are audit ready.
• Maintain awareness of payer-specific policies and proactively adapt workflows to remain in compliance.

Qualifications

Proficiency with enrollment and credentialing systems :

Experience with billing systems and claim platforms :

Ability to :

Benefits

Salary : $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).

Equal Opportunity Employer

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

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

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