AmeriHealth Caritas · 9 hours ago
Vice President Provider Enrollment Service
United States
Full-time
Remote
Director/Executive
10+ years expAmeriHealth Caritas is a mission-driven organization with over 30 years of experience in delivering comprehensive health care solutions. The Vice President, Provider Enrollment Services is responsible for the enterprise direction of provider enrollment activities, ensuring compliance with regulatory standards and overseeing provider network development.
Health CareInformation Technology
Responsibilities
Responsible for the strategy, direction and accountability for all provider enrollment activities and projects. Includes oversight and accountability for the front-implementation of enterprise-wide solutions
Accountable for meeting established regulatory, contractual, and operational standards and goals as it relates to the performance and services of the enterprise provider enrollment functions. This includes achievement of all processing time to process requirements and all internal and external quality levels for each provider update metric
Interfaces with external stakeholders (e.g. high-profile providers) and internal clients, (health plan and network development leaders) to assist with and resolve issues and support corporate initiatives
Accountable for processing provider data from various external sources. Partners with various stakeholders to create and implement strategies to meet market and industry requirements
Responsible for developing and implement provider enrollment strategies leveraging internal systems, processes and structure in order to meet market demands and corporate initiatives, e.g., new market entry
Collaborates with other core functions within Enterprise Operations and the company to drive increased automation of and optimization of all functions
Partners with Workforce Management, Quality Assurance and Training to ensure appropriate capacity and staffing levels for ongoing and future operations
Oversees large, multi-site, high volume processing team and support vendors
Presents strategies, issues, updates and results to all levels of management including the CEO. Is responsible for the outcome of Provider Enrollment Services across the enterprise
Contributes to the development of new workflows, structure, policies and procedures as necessary to ensure departmental activities are consistent with corporate strategy and business development initiatives
Responsible for associate development within teams. Holds associates accountable for meeting departmental goals
Responsible for establishing and meeting all budgetary goals
Qualification
Required
Bachelor's Degree preferred or subsequent work experience
Experience working in a large highly matrixed organization, with proven ability to develop internal enterprise relations, and external relationships with the medical community
Ability to lead teams and direct workflow across several departments and functions
Ability to travel approximately 15-20% of the time
Previous experience evaluating and developing operational strategy and performance in a metrics-based environment
Prior staff management experience required with demonstrated success in managing and motivating a large staff, including virtual staff, across multiple locations
Deep understanding of claim processes and edits, member enrollment and provider data; experience with FACETS and provider enrollment/maintenance systems a plus
10 to 15 yrs. experience in Health Care; 10 -12 yrs. Provider operations management experience, experience managing a provider data activities and production teams large in multiple locations
Benefits
Flexible work solutions including remote options
Hybrid work schedules
Competitive pay
Paid time off including holidays and volunteer events
Health insurance coverage for you and your dependents on Day 1
401(k)
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
H1B Sponsorship
AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (18)
2024 (17)
2023 (12)
2022 (14)
2021 (4)
2020 (11)
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
Company data provided by crunchbase