Payer Enrollment Supervisor

Responsibilities:

Oversee the end-to-end payer enrollment and maintenance lifecycle for individual and group providers, including initial enrollments, revalidations, re-credentialing-related enrollment activities, demographic updates, roster submissions, and other payer requirements, ensuring accuracy, timeliness, and compliance.

Supervise, coach, and support payer enrollment staff through workload oversight, training, performance management, and quality review to ensure consistent and high-quality execution.

Serve as a subject matter expert on commercial payer enrollment requirements and participation standards, providing guidance on complex enrollment matters and serving as an escalation point for payer, provider, and enrollment issues.

Oversee ongoing CAQH profile maintenance, including provider demographics, practice information, credentials, attestations, re-attestations, and supporting documentation; establish controls to monitor expirations and outstanding updates.

Monitor enrollment applications, payer statuses, rosters, and effective dates to proactively identify delays, discrepancies, and risks to provider participation or billing readiness, ensuring providers remain active with contracted payers.

Communicate directly with commercial payers to clarify requirements, resolve enrollment issues and discrepancies, address delays, and escalate complex matters as needed.

Collaborate cross-functionally with Credentialing, Contracting, Compliance, Legal, Provider Operations, Revenue Cycle, Billing, and other teams to ensure alignment across provider data, contracts, credentialing, enrollment, and billing readiness.

Maintain accurate and complete enrollment records and documentation across enrollment and provider data systems, ensuring data integrity and readiness for internal audits and compliance reviews.

Develop, implement, and continuously improve payer enrollment policies, procedures, workflows, and controls to support consistency, scalability, compliance, and operational efficiency.

Track and report enrollment metrics, turnaround times, application statuses, CAQH maintenance, and other key performance indicators; identify trends, operational risks, and opportunities for improvement.

Lead process improvement and automation initiatives to reduce enrollment processing times, improve accuracy, enhance visibility, and strengthen the provider and internal stakeholder experience.

Stay current on payer requirements, CAQH processes, state and federal regulations, and industry best practices, partnering with leadership to proactively address changes and strengthen payer enrollment strategy and provider revenue readiness.

Qualifications:

Bachelor’s degree preferred (or equivalent work experience).

4+ years of payer enrollment experience in a healthcare organization, medical group, health plan, hospital, CVO, or behavioral health setting.

2+ years of experience in a lead or supervisory role preferred.

Proven ability to coach, manage accountability, and lead a team to maintain high standards of quality and timeliness.

Deep working knowledge of commercial payer enrollment processes,provider participation requirements, roster management, revalidations, and platforms including CAQH, NPPES, PECOS, payor portals, credentialing software, and ticketing systems (e.g., CredentialStream, Salesforce, Zendesk).

Strong understanding of how credentialing, contracting, enrollment, and revenue cycle operations interconnect, with a track record of scaling and improving operational workflows.

Highly detail-oriented self-starter who manages competing deadlines, drives process follow-through, and exercises sound judgement when resolving complex payor and provider escalations. 

Exceptional analytical, organizational and interpersonal skills to collaborate effectively across departments, service lines and leadership levels. Proven ability to build, improve, and scale operational processes.