Medical Provider Enrollment Lead

Are you an expert in the complexities of Medicare and Medicaid who thrives on high-stakes growth? As a Provider Enrollment Team Lead, you won’t just manage a queue—you’ll be the architect of a national footprint. We are looking for a PECOS and MAC portal power-user to lead a high-performing team, streamline multi-state telehealth workflows, and ensure our providers are ready to deliver care without delay. If you’re ready to turn "compliance" into a "competitive advantage," apply now. Requirements:

• 5+ years of experience in provider enrollment, with a focus on multi-state Medicare and Medicaid
• Hands-on expertise in MAC portals, state Medicaid portals, and PECOS
• Deep understanding of CMS-855 enrollment forms, reassignments, and ownership structures
• Proven experience managing multi-state payer enrollment workflows
• Experience leading or mentoring provider enrollment or credentialing teams
• Knowledge of healthcare payer regulations, compliance, and enrollment lifecycle management
• Excellent organizational, communication, and escalation skills

Please complete the prescreening questionnaire and you will be able to get on our recruiters calendar.

salary: $24 - $25 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

• Lead and manage enterprise-wide enrollment strategies for individual practitioners and group entities across multiple state jurisdictions.
• Direct all phases of the enrollment lifecycle: initial filings, revalidations, ownership updates (CHOW), and reactivations.
• Act as the primary subject matter expert for federal enrollment systems and CMS compliance requirements.
• Audit and validate the submission of standard CMS-855 forms and diverse state-specific Medicaid applications.
• Maintain data integrity across all primary source systems, including federal databases and state-specific portals.
• Navigate and optimize workflows within various regional Medicare Administrative Contractor (MAC) portals and state Medicaid systems.
• Manage high-volume portal communications, including development letters, audit responses, and revalidation notices.
• Standardize the internal response process for payer inquiries and deficiencies to meet strict filing deadlines.
• Maintain rigorous documentation standards for all payer correspondence and approvals.
• Establish and monitor Key Performance Indicators (KPIs) and Service Level Agreements (SLAs) for application turnaround times.
• Credentialing & Expansion Support
• Oversee the maintenance of CAQH profiles and universal provider data sets.
• Ensure compliance with evolving state-specific rendering location requirements and multi-state licensure rules.

Skills

• Medicare/Medicaid Enrollment (5 years of experience is required)
• MAC portals (4 years of experience is required)
• PECOS Administration (2 years of experience is required)
• Leadership (2 years of experience is required)
• Compliance and Regulations (4 years of experience is required)

Qualifications

• Years of experience: 5 years
• Experience level: Manager

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.