Summary

As a Provider Enrollment Manager at HMS, you will have a critical role in supporting access to care by ensuring qualified providers are enrolled to deliver services to Medicaid members, directly impacting healthcare delivery across the community. You will be responsible for overseeing the day-to-day operations of provider enrollment activities within the Alaska Medicaid program. This position ensures compliance with state and federal regulations, manages team performance, and partners closely with the client, providers, and internal stakeholders to deliver accurate, timely, and high-quality enrollment processing. Your work directly supports the Account Delivery Manger (ADM), Regional Leader, and internal business partners in achieving or exceeding contractual obligations and company goals and objectives.

Your role in our mission

HMS empowers you through innovative technologies and solutions to deliver better health and human services outcomes. When joining HMS, you will:

• Manage the end-to-end Medicaid provider enrollment process, ensuring compliance with CMS and state requirements. 
• Day-to-day operations of the provider enrollment lifecycle including new enrollments, revalidations, and maintenance updates. 
• Supervise staff performance to meet or exceed Service Level Agreements, turnaround times, and quality targets. 
• Ensures compliance with state and federal regulations, manage team performance, and partners closely with clients and internal stakeholders to deliver accurate, timely, and high-quality enrollment processing. 
• Utilize the Medicaid Management Information System (MMIS) as the system of record for updating provider data, uploading approved enrollment documents, and maintaining data accuracy. 
• Oversee workflow and document processing using OnBase (Hyland) for document imaging, indexing, and secure storage. 
• Use Verint Workforce Management (WFM) tools to monitor productivity, adherence, and staffing needs. 
• Develop and maintain Standard Operating Procedures, training materials, and quality control procedures. 
• Analyzes trends and data to guide strategic planning and continuous improvement initiatives. 

What we're looking for

• Bachelor’s degree in healthcare administration, business administration, public health, or a related field. 
• Minimum of five (5) years of experience in Medicaid provider enrollment, credentialing, or similar healthcare operations functions. 
• At least three (3) years supervisory or management experience, leading teams in an operational or production-driven highly matrixed environment. 
• Working knowledge of Medicaid Management Information Systems (MMIS) and Medicaid provider data standards. 
• Exceptional written and oral communication and people skills. 

What you should expect in this role

• Hybrid role with ability to work in the Anchorage, AK office preferred, with the possibility of working remotely from another state for the right candidate. 
• The person will need to work Alaska Standard Time (AKST) hours. 
• For positions assigned to WFH, reliable high-speed internet connection is required. 

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*This posting is intended for pipelining. We will accept applications on an ongoing basis.