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OpenLoop is a telehealth platform that powers virtual care delivery across all 50 states. The Enrollment team is responsible for keeping clinicians enrolled and in good standing with Medicare, Medicaid, and commercial payers—the critical foundation enabling patients to access covered care and receive reimbursement.
As Manager of Enrollment, you will lead a team of 51 enrollment specialists split between US-based staff handling government payer enrollment (Medicare/Medicaid) and an offshore team managing high-volume commercial payer enrollment across multiple states. Your core responsibilities include:
• Team Leadership & Structure: Manage and develop the 51-person team, build out a management layer (leads/supervisors) as needed to maintain quality and coaching at scale, and establish clear escalation paths.
• Workflow & Accountability: Build structure and prioritization into daily operations—set queues, deadlines, and accountability standards to ensure applications are submitted accurately and on time.
• Root-Cause Analysis: Own investigation of denied enrollment applications, identify denial patterns, determine which can be corrected and resubmitted, and drive process improvements to reduce denial rates.
• Payer Relations: Hold payers accountable to expected turnaround times and follow-up cadences; escalate and resolve stalled or at-risk applications.
• Stakeholder Communication: Serve as the primary point of contact between the Enrollment team and internal client-facing programs, translating enrollment status and blockers into clear updates.
• Cross-Functional Collaboration: Partner with Revenue Cycle Management, Sales, Payer Contracting, Medical Staff Credentialing, and Compliance/Legal to align enrollment with new contracts, provider onboarding, and regulatory requirements.
• Systems & Reporting: Help build and manage a ticketing workflow (Jira) for the enrollment queue; track and report on team throughput, application volume, and denial/approval trends.
• Team Development: Coach and develop team members, set goals, manage performance, and support career growth.
You bring 5+ years of provider/payer enrollment, credentialing, or payer relations experience with direct exposure to both government and commercial payers. You have 2+ years of demonstrated people leadership experience managing large, high-volume operational teams (ideally 25+ staff) through sub-leads/supervisors, not just direct 1:1s. Direct telehealth experience is strongly preferred, as is comfort with multi-state or multi-region private practice enrollment. You understand the practical differences between commercial, Medicaid, and Medicaid Advantage enrollment. You are comfortable digging into denial and process data to find root causes. You have working knowledge of enrollment and credentialing systems (MDStaff, CAQH, PECOS) and are open to adopting new workflow tools. You communicate clearly in writing and verbally, act as connective tissue across teams, and have a track record of building process and structure in fast-moving environments.
