AmeriHealth Caritas · 1 week ago
Provider Enrollment Team Lead
United States
Full-time
Remote
Mid, Senior Level
3+ years expAmeriHealth Caritas is a mission-driven organization with over 30 years of experience in delivering comprehensive healthcare solutions. The Provider Enrollment Team Lead is responsible for overseeing provider requests, training new associates, and ensuring accurate processing of provider enrollment requirements.
Health CareInformation Technology
Responsibilities
Create, update, and maintain training materials, standard operating procedures (SOPs), bulletins, and online help resources
Review and assist associates with complex and high‑risk provider requests and records, including sanctions, disciplinary actions, and cases where provider enrollment requirements are not met
Monitor workflow inventory to ensure requests are assigned appropriately and work is completed within established service-level agreements (SLAs)
Research and analyze issues identified by clients or internal departments and recommend accurate, timely solutions. Serve as a liaison with internal and external stakeholders to troubleshoot and ensure efficient work processes
Complete departmental reports and logs as assigned. Communicate notifications, updates, and bulletins to all relevant departments
Participate in meetings and workgroups with internal and external departments to resolve provider‑related discrepancies, claims issues, and other cross‑functional concerns
Assist with mapping claims in the Invalid Provider Queue and support resolution of provider‑related claim suspensions
Support the execution of panel transfer processes, panel releases, and primary care provider (PCP) assignments as needed
Perform additional duties as assigned to support the Supervisor and Manager
Qualification
Required
Minimum of 3 years of related experience in Provider Services, Claims, or Call Center operations
Minimum of 2 years of Provider Maintenance experience
Proficiency with Microsoft Office applications (Excel, Word, Access)
Strong verbal and written communication skills
Ability to plan, prioritize, and manage workload independently to meet deadlines
Proficiency with internal systems and applications used for provider data and workflow management (e.g., Healthcare System, LIFT, & Facets)
Preferred
Associate's degree preferred; equivalent work experience accepted
Knowledge of basic healthcare and managed care principles, as well as medical terminology, preferred
Benefits
Flexible work solutions include remote options, hybrid work schedules
Competitive pay
Paid time off
Holidays and volunteer events
Health insurance coverage for you and your dependents starting Day 1
401(k) retirement savings plan
Tuition reimbursement
And more.
Company
AmeriHealth Caritas
AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Kathleen Giblin
SVP Clinical Operations
Ash Hanson
Executive Vice President & Chief Human Resources Officer
Recent News
2025-11-06
The Philadelphia Inquirer
2025-10-02
2025-10-01
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