Director, Out of State Medicaid (REMOTE)

@ EnableComp
EnableCompenablecomp.com

Director, Out of State Medicaid (REMOTE)

Posted 2 days ago

About the job

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare, using AI and automation to improve financial outcomes for hospitals, clinics, and insurers nationwide.

Requirements

  • 7-10 years management or supervisory experience
  • Healthcare or managed care industry background
  • Knowledge of insurance claims processing
  • Strong computer proficiency (MS Office)
  • Experience leading large teams

Qualifications

  • Bachelor’s degree preferred
  • High School Diploma required
  • Strong leadership and communication skills
  • Ability to handle multiple projects
  • Knowledge of healthcare financials

Full job description

EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM™ intelligent automation platform to improve financial sustainability for hospitals, health systems, and ambulatory surgery centers (ASCs) nationwide. Powered by proprietary algorithms, iterative intelligence from 10M+ processed claims, and expert human-in-the-loop integration, EnableComp provides solutions across the revenue lifecycle for Veterans Administration, Workers’ Compensation, Motor Vehicle Accidents, and Out-of-State Medicaid claims as well as denials for all payer classes. By partnering with clients to supercharge the reimbursement process, EnableComp removes the burden of payment from patients and provider organizations while enabling accelerated cash, higher and more accurate yield, clean AR management, reduced denials, and data-rich performance management. EnableComp is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list of the fastest-growing private companies in the United States for the last eleven years. 

POSITION SUMMARY

The Director, OSM is a key leader within the Out-of-State Medicaid function responsible for driving performance, operational execution, and client outcomes across multiple teams. This role oversees Managers, Supervisors, and Revenue Specialists, ensuring alignment of day-to-day operations with departmental strategy, revenue targets, and client expectations. The Director is accountable for setting priorities, optimizing resource allocation, and delivering consistent, high-quality results through effective leadership, performance management, and cross-functional collaboration. In partnership with senior leadership, this role identifies opportunities for continuous improvement, enhances operational efficiency, and develops leadership capability within their span of control to support sustained performance and growth.


JOB RESPONSIBILITIES

  • Ensure the processes and inventory are in place to hit monthly, quarterly, and annual revenue expectations for the company. 
  • Lead multiple teams through Managers and Supervisors by establishing daily, monthly, and strategic goals, ensuring alignment to revenue targets and operational priorities.
  • Oversee hiring, onboarding, and performance management across assigned teams, ensuring strong leadership capability and team effectiveness.
  • Oversee performance management processes, including goal setting, performance reviews, and accountability frameworks across Managers and Supervisors.
  • Oversee workload distribution and capacity planning across teams to ensure efficient execution and alignment with business priorities.
  • Perform regular audits and client reviews ensuring EC is delivering all requirements to the satisfaction of the client.
  • Measures and monitors key performance metrics and delivers concise performance reporting to stakeholders with corrective action plans for variances when appropriate.
  • Assists in setting the strategic direction of the Out-of-State Medicaid team and identifies areas of continuous improvement in conjunction with the leadership team.
  • Maintain a strong knowledge of insurance billing and reimbursement procedures and regulations.
  • Researches and analyzes collections systems processes in Enforcer, including process improvement and SOP enhancement recommendations. 
  • Coordinate cross-functional resources to execute action plans for assigned accounts and resolve operational challenges impacting performance.
  • Oversee the implementation and adherence to quality and productivity standards across teams, ensuring consistency and accountability.
  • Set and adjust priorities across teams to ensure optimal resource allocation and focus on the most impactful and profitable work.
  • Ensure compliance with HIPAA and related regulatory requirements through oversight of processes, policies, and team adherence.
  • Hold Managers and Supervisors accountable for team performance, including productivity, quality, and adherence to workflows and service level expectations.
  • Develop and strengthen leadership capability by coaching Managers and Supervisors, building a pipeline of future leaders.
  • Provide guidance and oversight on complex performance management matters, ensuring consistent application of expectations and company policies.
  • Support operational and business transformation initiatives, ensuring adoption and execution across teams.
  • Maximize efficiency and productivity through extensive process analysis and interdepartmental collaboration.
  • Assist with audits and client reviews ensuring EC is delivering all requirements to the satisfaction of the client.
  • Other duties as required

REQUIREMENTS AND QUALIFICATIONS

  • Bachelor’s degree in business or healthcare administration preferred. High School Diploma or GED required.
  • 7-10 years’ experience in management or supervisory experience with team size of 10+.
  • 6+ years’ experience in healthcare setting, information technology company or managed care industry, preferably in the area of Finance/Collections, Business Operations or Revenue Recovery. 
  • Experience working with internal teams while serving in a client facing or client support role.
  • Knowledge and understanding of financials, HMO’s, hospital revenue cycle process, ancillary and provider contract language and familiarity with healthcare and provider data sets.
  • Extensive level of understanding of insurance payer/provider claim processing and subsequent data requirements.
  • Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
  • Timely and regular attendance.
  • Equivalent combination of education and experience will be considered
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions.

    • SPECIAL CONSIDERATIONS & PREREQUISITES

  • Practices and adheres to EnableComp’s Core Values, Vision and Mission
  • Strong and professional written and oral communications skills.
  • Has worked in a production environment and can meet deadlines. 
  • Excellent people skills to interface with multiple internal stakeholders.
  • Demonstrated ability to successfully work collaboratively within a team and cross-functionally.
  • Proven success in obtaining quantifiable results from and setting priorities for direct reports. 
  • Organized and can handle multiple projects simultaneously.
  • Ability to set and manage multiple priorities among several teams. 
  • Experience communicating obstacles & challenges and developing action plans to present to management. 


    • EnableComp is an Equal Opportunity Employer M/F/D/V. All applicants will be considered for this position based upon experience and knowledge, without regard to race, color, religion, national origin, sexual orientation, ancestry, marital, disabled or veteran status. We are committed to creating and maintaining a workforce environment that is free from any form of discrimination or harassment.

    EnableComp recruits, develops and retains the industry's top talent.  As the employer of choice in the complex claims industry, EnableComp takes pride in our continuous commitment to building and maintaining a culture centered around fostering the professional growth and development of our people.  We believe that investing in our employees is the key to our success, and we are dedicated to providing them with the tools, resources, and support they need to thrive and grow their career here. At EnableComp, we are committed to living up to our core values each and every day, and we believe that this commitment is what sets us apart from other companies.  If you are looking for a company that values its employees and is dedicated to helping them achieve their full potential, then EnableComp is the place for you.

    Don’t just take our word for it!  Hear what our people are saying:

    “I love my job because everyone shares the same vision and is determined and dedicated. People care about you as a person and your professional growth. There is a genuine spirit of cooperation and shared goals all revolving around helping each other.” – Revenue Specialist

    “I enjoy working for EnableComp because of the Core Values we believe in. EnableComp stands true to these values from empowering employees to ecstatic clients. This company is family oriented and flexible, along with understanding the balance of work, life, and fun.” – Supervisor, Operations

    Show full description

    Similar jobs in Columbus, OH

    See all Director jobs