AdventHealthRegulatory Licensure and Enrollment Manager
Altamonte Springs, FL

AdventHealth Corporate

All the benefits and perks you need for you and your family:

· Benefits from Day One

· Career Development

· Whole Person Wellbeing Resources

· Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Shift : Monday-Friday

Job Location : Altamonte Springs, FL

The role you’ll contribute:

The Regulatory Licensure and Enrollment Manager, working with the Director over Regulatory Licensure and Enrollment, is responsible for understanding facility licensure regulations and processes as well as Medicare and National Plan and Provider Enumeration System (NPPES) enrollment in order to provide the required monitoring, creation, and maintenance functions. In addition to ensuring operational compliance with facility specific licensure and enrollment regulations, this position assists with research and activities for acquisition related licensure and enrollment activities and required filings. As a member of the AHS Advocacy and Public Policy team, the Regulatory Licensure and Enrollment Manager will proactively recommend and participate in process changes that will improve operations and support our strategic initiatives and growth. The Regulatory Licensure and Enrollment manager must be able to develop strong working relationships with AHS executives, Regulators, and other internal and external stakeholders.

The value that you bring to the team:

LICENSURE:

Transactions

· Actively participates in business acquisitions.

· Reviews and prepares listing of current licenses inventory.

· Prepares tracking list of licenses to be completed for the transaction based on facility type and State and Federal requirements.

· Creates and submits licensure applications as required by facility type and State and Federal requirements.

· Tracks progress of required applications and other regulatory items throughout the transaction process.

· Actively participates in transaction group meetings and discussion.

· Communicates with State and Federal agencies as needed.

· Assures required licenses and permits are in place within State or Federal time requirements.

· Creates and maintains an electronic record of the project files.

Licenses & Permits, New

· Actively participates in new projects; facility construction, laboratory, pharmacy, and others.

· Prepares listing of licenses and permits required by project type and State and Federal requirements.

· Creates and submits licensure applications as required by project type and State and Federal requirements.

· Tracks progress of required applications and other regulatory items throughout the construction process.

· Actively participates in the new project group meetings and discussion.

Licenses & Permits, Existing

· Tracks license renewals for Hospital, Home Health, Hospice and Laboratory locations.

· Assists with renewal applications and requirements as requested.

· Assists with changes to licensure during the current licensure period.

· Communicates with state agencies as needed.

· Assures licenses are renewed and distributed.

· Assures changes to licensure during the current licensure period are completed and submitted.

· Creates and maintains an electronic record of the licensure files.

Background screening

· Maintain access to any State required online background screening portal to assist with new or existing screening requirements.

Special Projects

· Actively researches or shares knowledge of regulatory requirements for special projects as requested.

· Reviews legislation and/or administrative rules for impact to the health care industry.

· Reviews and submits hospital, home health, and hospice state required proof of liability coverage.

· Researches and provides guidance for additional requests for related to State and Federal regulations.

MEDICARE, MEDICAID & NPPES ENROLLMENT:

New Medicare Enrollments; CHOWs (Change of Ownership), Revalidations, Critical Updates

· Utilizes PECOS system (Medicare Provider Enrollment, Chain, and Ownership System) for all necessary enrollment transactions when feasible.

· Performs initial clean-up of existing and any newly assigned Medicare Enrollment’s (855s).

· Works with facility contacts to validate all information on the enrollment and obtains necessary supportive documentation.

· Actively participates in business acquisitions.

· Prepares/updates project and facility data spreadsheets with enrollment information to be completed for the transaction/project based on facility type and Federal requirements.

· Creates and submits enrollment applications as required by facility type and Federal requirements.

· Tracks progress of required applications and other regulatory items throughout the transaction process/project.

National Plan & Provider Enumeration System NPPES)

· Creates applications for new National Provider Identifier (NPI) numbers as requested through the NPPES system.

· Maintains NPPES system and updates with any necessary changes.

· Communicates with Federal agencies or MAC (Medicare Administrative Contractors) / Fiscal Intermediaries as needed.

Acquired and Existing Medicaid enrollments; CHOWs (Change of Ownership), Renewals, Critical Updates

· Utilizes the appropriate state Medicaid site for transactions as requested.

· Performs initial clean-up of CFN existing and any new Medicaid Enrollment’s as requested.

· Works with Facility contacts to validate all information on the enrollment and obtains necessary supportive documentation.

· Actively participates in business acquisitions.

· Prepares/updates Project and Facility spreadsheets of enrollment information to be completed for the transaction/project based on facility type and requirements.

· Creates and submits enrollment applications as required by facility type and State requirements.

· Tracks progress of required applications and other regulatory items throughout the transaction/project process.

· Actively participates in transaction/project group meetings and discussion.

Disenrollments

· Perform all steps necessary to disenroll AdventHealth entities from the Medicare or Medicaid Program as necessary and authorized.

· Communicates with Federal agencies or MAC (Medicare Administrative Contractors) / Fiscal Intermediaries as needed.

The expertise and experiences you’ll need to succeed :

· Bachelor’s Degree in Health Law, Health Care Administration, Business, Communications or other related or approved field.

· 1-3 years of experience in Healthcare, Healthcare Compliance, or Health Care Regulations or Medicare and/or Medicaid Enrollment.

Preferred qualifications:

· Master’s Degree in Health Law, Health Care Administration, Business, Communications or other related or approved field.

· 3-5 years of experience in Healthcare, Healthcare Compliance, or Health Care Regulations or Medicare and/or Medicaid Enrollment.

· Knowledge and understanding of health care regulations and regulatory reporting requirements

· Knowledge of PECOS Medicare Enrollment System

· In-depth knowledge and ability to navigate AHS’ multiple information systems

· Must be a team-oriented, self-motivated professional with leadership, interpersonal, organizational, and planning skills

· Notary Certification for the State of Florida

· Certification in Health Care Compliance

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Job Snapshot

  • Job Schedule: Full-time

    Pay Range: $44.06 - $66.09

  • Location: Altamonte Springs, FL

  • Job ID: 24004669

  • Job Family: Operations

  • Shift: 1 - Day

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