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Job Description

About the Role:

As Director of Payer Enrollment, you will play a crucial role in the leadership of our

Payer Enrollment team. Our PE Team is core to our business and is responsible for making sure

payer enrollment execution runs smoothly. You are succeeding in this role when the PE team is:

scaling efficiently, making high quality, data-driven decisions, and embracing a culture of

continuous process improvement.

We’re looking for someone who has the ability to act tactically as well as strategically,

possesses extensive work experience related to task-based workflows and quality metrics

(KPI’s), as well as a demonstrated ability to drive results across a variety of workstreams. The

ideal candidate is extremely comfortable conducting ongoing performance analysis and is able

to identify meaningful opportunities with both internal and external stakeholders and define and

implement subsequent action plans.

The role will report directly to the Senior Director of Operations.

Responsibilities:

• Develop and manage Payer Enrollment leaders at various levels of professional tenure.

Help your direct reports grow their skills via mentorship, 1:1s, and reviews

• Support measuring and planning for the team’s performance, capacity, and growth

targets

• Implement new, as well as optimize existing, tools, processes, systems, and products

that streamline the Payor Enrollment team’s work and increase their efficiency/accuracy

(i.e standardized playbooks, communication templates, training materials, resource

guides, automation features, advanced tooling, etc.)

• Works with both internal and external stakeholders to resolve complex provider

enrollment issues as they arise

• Owning, measuring, and providing insights on renewal forecasts, customer health,

customer surveys, and product usage.

• Serve as the primary point of contact for customer-facing issues related to overall

performance and/or quality to effectively resolve escalations.

• Manage and improve the systems that help support the team’s processes. Current

systems include proprietary and public ones (e.g. Front, GSheets, Salesforce)

• Design and conduct training regarding provider enrollment process and systems/process

improvement initiatives

• Constantly learn about industry best practices and bring new ideas to the organization

about how to drive efficiency, growth and customer outcomes

• Direct ownership over Medallion’s PE function to consistently drive operational

excellence and cost efficiency.

• Certifications: Consider requiring or preferring certifications such as CPCS (Certified

Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services

Management).

Industry Network: Established relationships with payer representatives and industry

associations.

• Crisis Management: Experience managing large-scale disruptions (payer policy

changes) with resilience and minimal customer impact.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to [email protected] learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

Skills and Requirements

• 10+ years of experience in payer enrollment, with a focus on enrolling providers with

multiple payers, including commercial, Medicaid, and Medicare.

• Proven ability to manage high-volume enrollments (5,000+ enrollments weekly)

across multiple payers.

• Experience in working with healthcare providers and understanding of credentialing

processes

Minimum of 5 years in a leadership role, managing payer enrollment teams or related

operational functions.

• Strong ability to lead, motivate, and manage a team in a fast-paced, dynamic

environment.

• Proficiency with enrollment and credentialing software tools (e.g., CAQH, PECOS,

Availity, or other payer portals).

• Familiarity with workflow automation tools and software to streamline payer

enrollment processes.

• Strong data analysis skills to assess enrollment trends and performance metrics.

• Experience leading Global teams of 100+ ○ Strong problem-solving and decision-making skills, especially when dealing with

complex payer enrollment challenges.

• Excellent communication skills, with the ability to liaise between providers, internal

teams, and external payers effectively.

• Ability to multitask, prioritize, and manage large-scale projects with tight deadlines.

• Strong organizational and project management skills to handle high-volume

enrollments.

• Detail-oriented and committed to maintaining compliance with regulatory standards

and payer requirements