**Description** Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? **Payer Enrollment Manager** Job Summary: + The Payer Enrollment Manager is responsible for all aspects of payer enrollment operations of the Penn Medicine Corporate Office of Medical Affairs ("OMA") directly including, but not limited to, its NCQA certified Credentials Verification Organization ("CVO). CVO completes and maintains enrollment of 6000 employed and billable Penn Medicine providers with 75 government and managed care payers, required in order to bill their claims and be paid for their professional services. This function directly impacts Penn Medicine revenue and cash generation. + The Payer Enrollment Manager will report to the Payer Enrollment Senior Manager. Responsibilities: + Manages CVO payer enrollment supervisors and their activities, described below. Ensures that the Penn Medicine CVO continues to operate in an efficient and effective manner and maintains its NCQA CVO certification. + Designs payer enrollment processes and in prioritizing and assigning resources devoted to payer enrollment process improvement, ensuring an appropriate level of quality control over the payer enrollment work product. + Ensures an operational focus on timely processing to ensure quick and efficient claims processing, including but not limited to: + Government payer enrollment is conducted in a complete, correct and timely fashion so that to the maximum extent possible each provider’s effective date is on/before the provider start date; + Managed care payer enrollment is exported timely each month (or as otherwise appropriate) in a complete, correct and timely fashion so that to the maximum extent possible each provider’s effective date is on/before the provider start date, aging reports are sent on a regular basis to payers and follow-up communications are conducted as necessary to ensure that payers are following the turnaround times established in the delegated credentialing contracts, and that Managed Care staff are engaged to assist in issue resolution at the earliest appropriate time; + Behavioral health payer enrollment is conducted in a complete, correct and timely fashion so that to the maximum extent possible each provider’s effective date is on/before the provider start date; + Enrollment edits, those claims which cannot be sent to payers due to missing/incomplete/incorrect provider enrollment information, are reviewed regularly and rigorously through establishment, maintenance, and oversight of work queues, and distributed to departments and other stakeholders (such as the Physician Billing Office) for their review and management as applicable; + Collect and communicate information required by CMS and the payers necessary to support delegated credentialing contracts (e.g. directory data); + CVO and the Penn Medicine hospital Medical Staff Offices (“MSOs”) are compliant with all applicable standards/regulatory requirements for and payer credentialing; provide related regulatory/survey support to the same entities; and in concert with the Manager of Credentials and Privileging, successfully conduct and pass payer surveys. + Ensures that all staff have the necessary and appropriate training to be successful in their work. + Represents CVO payer enrollment in meetings with clients and payers. + Ensures that OMA is providing excellent service to its customers; + Responsible for enrollment aspects of CVO integration projects; + Attends and represents CVO payer enrollment in the Users Group and other operational meetings; + Assists in payer contract negotiation and contract implementation; and + Oversight of new practice onboarding efforts. + Performs duties in accordance with Penn Medicine and entity values, policies, and procedures. + Other duties as assigned to support the unit, department, entity, and health system organization. Education and/or Experience: + Bachelor's Degree (Required) + 7+ years of experience in claims processing, provider billing, revenue cycle or related work (Required) + Master's Degree (Preferred) Skills & Abilities: + Must have the ability to maintain information in a confidential manner in accordance with all regulatory requirements + Must be able to work effectively as a team leader, build effective teams and drive employee engagement + Must be able to meet deadlines and conduct operations within budget + Must be able to exercise good judgment when escalating issues + Strong verbal and written communication skills to enable sufficient, timely and effective communications with providers and external contacts + Proficient in computers and computer software including, but not limited to, database management, spreadsheet and word processing applications. + Microsoft Office Suite + Advanced training in database management, preferred We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives. Live Your Life's Work We are an Equal Opportunity and Affirmative Action employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law. REQNUMBER: 248988