Provider Enrollment Advisor- Nevada (Remote)

Summary

The Provider Enrollment Advisor will support the Provider Enrollment Manager and team for Nevada Medicaid. This person will act as a subject matter expert for business applications and team processes. This role requires analysis of data to make recommendations that are cost effective and high-quality. This person supports the business meeting Federal, State and Agency guidelines and service level agreements with the client.

Your role in our mission

• Serve as the subject matter expert for provider enrollment requirements, ensuring compliance with regulatory and business standards.
• Analyze business needs, gather client requirements, and recommend process and system improvements to support operational goals.
• Develop business specifications and collaborate with technical teams on system enhancements, testing, and implementation activities.
• Manage project activities, timelines, and deliverables, ensuring deadlines and objectives are met.
• Utilize data analysis to identify trends, root causes, compliance risks, and process improvement opportunities, and provide actionable recommendations.
• Support corrective action plans, resolve complex business application issues, and exercise sound judgment in decision-making.
• Build strong stakeholder relationships, influence positive outcomes, and maintain a high level of accuracy and attention to detail.

What we're looking for

• Bachelor’s degree in a related field or an equivalent combination of education, training, and experience.
• Five or more years of experience in healthcare operations (managed care, provider, or member services).
• Three or more yearsof experience in provider credentialing and enrollment.
• Five or more years of experience in problem-solving, research, and process improvement.
• Knowledge of provider enrollment processes and requirements for CMS Federal and State Guidelines related to enrollment and reenrollment policies, preferred.
• Knowledge of NV Medicaid Guidelines, preferred.
• Six Sigma Lean Green or Black Belt certification, preferred.

What you should expect in this role

• This is a 100% remote position.
• Candidates must be available to work during Pacific Time Zone business hours.
• The deadline to submit applications for this posting is October 5, 2026
• #LI-REMOTE