Providence Health & Services Regulatory Enrollment Analyst in Portland, Oregon
Providence St. Joseph Health is calling a Regulatory Enrollment Analyst to our location in Renton, WA.
We are seeking a Regulatory Enrollment Analyst to be responsible for providing coordination of system-wide efforts to maintain accurate, timely, and current enrollment status with third party payors.
Primary areas of responsibility include: Consulting with System, Region, and Ministry on matters of Medicare and Medicaid enrollment, detail review of applications prepared by regional and ministry staff, submit completed applications to the respective third party agencies, respond to requests from the third party agencies, assisting the Manager Reimbursement and reimbursement staff with other projects.
The incumbent performs all duties in a manner that promotes Providence mission, values, and philosophy. In all aspects, he/she serves as a role model for the values and mission of the organization.
In this position you will have the following responsibilities:
Know, understand, incorporate and demonstrate the Providence Mission, Vision and Core Values in leadership behaviors, practices and decisions. Inspires others to reflect the Providence mission, vision, and core values.
Take the point position on projects related to enrollments and the enrollment update process for the System.
Analyze the reimbursement impact of proposed programs, services and operating strategies throughout the System. Develop recommendations to facilitate achievement of proposed objectives.
Establish and maintain strong relationships with external agencies including Medicare, Medicaid, or other agencies.
Escalate critical issues, changes, problems, or delays to the project sponsor and management.
Participate in system-wide meetings within assigned areas of responsibility, including: Reimbursement Resource Group.
Develop and maintain a current knowledge and understanding of existing and proposed regulations related to Medicare, Medicaid and other payor enrollment processes including those promulgated under health care reform.
Recommend new, or refinements to existing, system-wide processes and practices affecting third party enrollment functions with the goal of ensuring reliability and maintaining a high level of quality.
Required qualifications for this position include:
Bachelor’s degree in healthcare administration, finance/accounting, or business administration is required, or an equivalent combination of education and/or experience.
At least 5 years of progressive work experience in finance, operations or regulatory compliance.
Proven ability to set technology strategy
Possess knowledge of third party enrollment regulations and standards.
Proven skills in communicating with technical staff, and customers.
Preferred qualifications for this position include:
Specific experience with supplier enrollments for Medicare part A, Medicare part B, and MediCal (California Medicaid), and General Medicaid experience is preferred.
Prior Experience with SQL and Visio
Possess good decision-making skills blending analysis, wisdom, experience, and judgment.
Ability to plan, organize and effectively lead multi-disciplinary teams and projects and develop meaningful results within established timeframes.
Excellent interpersonal skills and demonstrate the ability to work with a wide variety of people, both internal and external to the System.
Effective written and oral communication and presentation skills and the ability to communicate complex information to diverse audiences.
Demonstrated management skills and ability to work effectively to build relationships with colleagues, customers, and executive management through positive interaction.
Proven ability to organize multiple projects, schedules, demand and to meet shifting priorities.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence St. Joseph health from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer a full comprehensive range of benefits - see our website for details
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Health Care
Other Location(s): Alaska-Anchorage, Oregon-Portland, California-Burbank, Washington-Spokane, California-Irvine
Req ID: 230518