Logo for Accede Solutions Inc (accedesol.com)

Medicaid Provider Enrollment Subject Matter Expert (SME)

Accede Solutions Inc (accedesol.com)

Role overview

Qualifications

  • 3–6+ years in provider relations, credentialing, or enrollment
  • Strong understanding of Medicaid regulations and credentialing standards (NCQA)
  • Proficiency in provider enrollment databases and Microsoft Office Suite
  • Bachelor's degree preferred (or equivalent work experience)

Responsibilities

  • Managing and submitting accurate, timely applications to state Medicaid agencies
  • Ensuring compliance with federal and state regulations regarding Medicaid provider enrollment
  • Supporting audits of enrollment applications and remediating data quality issues
  • Working with providers, clinics, and state agencies to resolve enrollment roadblocks

Key facts

  • Remote from: Anywhere
  • Fixed term
  • Senior (5-10 years)
  • English

Hard skills

Enrollment Management Auditing Physician Credentialing Compensation Analysis

Other skills

  • Microsoft Office
  • Relationship Management

About the company

Accede Solutions Inc (accedesol.com) logo

Accede Solutions Inc (accedesol.com)

Staffing & Recruiting

Company details

Company typeSME
IndustryStaffing & Recruiting

Links

Website LinkedIn See all jobs

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Job Title: Medicaid Provider Enrollment Subject Matter Expert (SME)
Duration: 12+ months
Location: Remote

Job Summary:
A Medicaid Provider Enrollment Subject Matter Expert (SME) ensures healthcare providers are properly credentialed, contracted, and enrolled in government-sponsored health plans. Responsibilities include managing complex enrollment applications, ensuring compliance with Medicaid/Medicare policies, auditing data, and acting as a lead contact for state enrollment systems.

Key Responsibilities
  • Enrollment & Credentialing: Managing and submitting accurate, timely applications to state Medicaid agencies and managed care organizations.
  • Policy Expertise: Ensuring compliance with federal and state regulations regarding Medicaid provider enrollment, including Fee-for-Service (FFS) and managed care.
  • System Auditing & Support: Supporting audits of enrollment applications, remediating data quality issues, and assisting with data mapping or provider enrollment system updates.
  • Relationship Management: Working with providers, clinics, and state agencies to resolve enrollment roadblocks.
Required Skills and Qualifications
  • Experience: Generally 3–6+ years in provider relations, credentialing, or enrollment, with deep knowledge of Medicaid/Medicare workflows.
  • Knowledge: Strong understanding of Medicaid regulations, credentialing standards (NCQA), and provider compensation models (e.g., FFS, risk).
  • Technical Skills: Proficiency in provider enrollment databases, state portals, and Microsoft Office Suite.
  • Education: Bachelor's degree preferred (or equivalent work experience)

Apply once. Then go straight to the hiring manager.

After you apply, unlock the direct contact details of the people who actually make the call. A quick follow-up makes you 5x more likely to land an interview.

MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
Unlocked after you apply
·

Related jobs

Worldwide

Other jobs at Accede Solutions Inc (accedesol.com)

Premium

Reach out to the hiring manager directly.

Gain access to the contact details of the hiring managers who actually decide, and reach out to network with them directly. That, plus more when you upgrade:

  • Full match report with fit score and gaps
  • Career diagnostics on how recruiters read you
  • Curated company matches and warm intros
  • 48h early access to new roles

Cancel anytime.

  • remote jobs
  • Medicaid Provider Enrollment Subject Matter Expert (SME)