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Director, Out of State Medicaid (REMOTE)

11 hours, 15 minutes ago
United States
Full-time
Lead
Operations Manager
Project and Program Management
HIPAA
Apply Now
EnableComp

EnableComp

EnableComp specializes in complex claims and specialty revenue cycle management solutions for healthcare providers, focusing on optimizing reimbursements for various claims types, including VA, Workers' Compensation, and Motor Vehicle Accidents, throug...

Insurance
251-1K
Founded 2000
View All Jobs 12

Description

  • Lead Managers, Supervisors, and Revenue Specialists to achieve daily, monthly, and strategic performance goals.
  • Ensure processes, inventory, and resource allocation support monthly, quarterly, and annual revenue targets.
  • Oversee hiring, onboarding, performance reviews, and accountability frameworks for assigned teams.
  • Monitor workloads, capacity planning, quality standards, productivity, and service-level adherence across teams.
  • Conduct audits and client reviews to ensure delivery against client requirements and satisfaction.
  • Track key performance metrics, prepare stakeholder reporting, and implement corrective action plans as needed.
  • Support strategic planning, continuous improvement, and business transformation initiatives for the Out-of-State Medicaid function.
  • Research and analyze collections system processes in Enforcer and recommend process and SOP improvements.
  • Coordinate cross-functional resources to resolve operational issues and execute action plans for assigned accounts.
  • Ensure compliance with HIPAA and related regulatory requirements across processes and team practices.

Requirements

  • High School Diploma or GED required; bachelor’s degree in business or healthcare administration preferred.
  • 7-10 years of management or supervisory experience leading teams of 10+ people.
  • 6+ years of experience in healthcare, information technology, or managed care, preferably in finance/collections, business operations, or revenue recovery.
  • Experience working in a client-facing or client support role while partnering with internal teams.
  • Strong understanding of financials, HMOs, hospital revenue cycle processes, provider contract language, and healthcare/provider data sets.
  • Extensive knowledge of insurance payer/provider claim processing and related data requirements.
  • Strong computer proficiency, including Microsoft Office (Word, Excel, and Outlook).
  • Timely and regular attendance is required.
  • Equivalent combination of education and experience will be considered.
  • Strong written and verbal communication skills and the ability to work in a production environment and meet deadlines.
  • Excellent interpersonal skills, collaboration, and ability to manage multiple priorities and projects simultaneously.
  • Experience presenting obstacles, challenges, and action plans to management.

Benefits

  • Top Workplaces award recipient.
  • Recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024.
  • Ranked among the top one percent of companies on the Inc. 5000 list for the last eleven years.
  • Commitment to employee growth, development, and career support.
  • Flexible, family-oriented work culture with emphasis on work-life balance.

Interested in this position?

Apply directly on the company website

Apply Now

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