Provider Enrollment and Network Mgmt Specialist

Lead with Purpose. Empower with Compassion. Voted Raleigh’s Best Nonprofit Organization and Raleigh’s Best Mental Health Services three years in a row!

• →Coordinate and manage organizational site and service enrollments with Commercial, Medicare, Medicaid, and Managed Care Organization (MCO) payers.
• →Prepare, submit, and track applications and supporting documentation required for new site, service, and program implementations.
• →Monitor enrollment status and conduct follow-up with payer representatives to ensure timely processing and implementation.
• →Coordinate site relocations, closures, service modifications, and organizational demographic changes with payers.
• →Assist with implementation of newly executed payer contracts by coordinating site and service participation with applicable payers and communicating updates to internal stakeholders.
• →Serve as the primary administrative contact for payer communications related to site and service participation.
• →Maintain payer directory accuracy and coordinate resolution of directory discrepancies.
• →Collaborate with Operations, Credentialing, Revenue Cycle Management, Quality Management, and program leadership regarding enrollment and implementation activities.
• →Support Electronic Health Record (EHR) improvement initiatives and payer incentive programs.
• →Maintain enrollment tracking logs, databases, and supporting documentation.
• →Prepare reports and provide regular status updates to leadership regarding enrollment and implementation activities.
• →Ensure the accuracy and completeness of enrollment records and related documentation.

We’re looking for someone who brings the experience, skills, and commitment needed to succeed in this role.

• Associate’s Degree in Healthcare Administration, Business Administration, or related field; or equivalent combination of education and experience.
• Three (3) years of experience in provider enrollment, managed care operations, credentialing support, healthcare administration, or related functions.
• Knowledge of payer enrollment and network participation processes.
• Strong organizational, project management, and problem-solving skills.
• Ability to manage multiple priorities and deadlines.
• Strong attention to detail and follow-through.
• Excellent verbal and written communication skills.
• Ability to work collaboratively across departments.
• Proficiency in Microsoft Office Suite, including Excel, Outlook, Word, SharePoint, and Teams.
• Driver’s license / insurance / travel / schedule requirement, only if applicable]
• Ability to maintain confidential and sensitive information

Easterseals PORT Health helps people with disabilities, mental health and/or substance use challenges, their families, and our employees embrace their potential, access opportunities, build resilience and thrive. Purpose, dedication, and empathy drive our in-person and telehealth service delivery.

Our 2,800-member team provides more than 10.2 million hours of meaningful support to 40,200 children, adults, and families in 11,000 home, facility, and community locations across North Carolina and Virginia.

Easterseals PORT Health is an Inclusive Culture, Different Voices, Embracing Potential, Authentic Self, and Learning and Growing.

Applicants of all abilities are encouraged to apply! Need assistance with the application process or an accommodation? Contact recruiter@eastersealsPORT.com.