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Health Consulting | Payer Enrollment and Billing Functional Expert (Manager/Sr. Manager)

We work with C-suite executives, leaders and boards of the world’s leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360° stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functional expertise is supported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization’s total enterprise reinvention.

As a Health Industry Enrollment and Billing Functional Expert , your primary responsibilities may include:    

Functional Expertise

• Serve as the subject matter expert (SME) for payer enrollment , billing , and financial processes, including fully insured, ASO, individual (both on and off exchange ), Medicare, and Medicaid

• Have deep understanding of operational integration with the upstream and downstream departments dependent on enrollment and billing, including but not limited to sales, marketing, broker operations, claims, fulfillment, remittance, payment processing, health plan finance and accounting, and risk adjustment .

• Analyze and map workflows within enrollment, billing and associated team s to identify inefficiencies and recommend improvements.

• Maintain a working knowledge of industry tools and technology that support enrollment and premium billing operations

  Client Engagement

• Collaborate with clients to gather business requirements and translate them into functional specifications.

• Facilitate workshops and stakeholder meetings to define enrollment and billing system capabilities and future-state processes.

• Provide strategic recommendations to enhance billing accuracy and payment reconciliation with groups, members, third party payers, states, and CMS

  Project Leadership

• Drive high quality deliverables by co ordinating cross-functional teams, managing timelines , and reporting progress to client leadership .

• Work closely with operational leaders and technical teams to ensure accurate configuration and customization of enrollment and billing platforms.

  Client Relationship Management

• Serve as the primary point of contact for senior client stakeholders, building and maintaining strong relationships and providing strategic guidance on billing , enrollment and finance operations .

• Conduct regular progress updates, issue resolution, and performance evaluations with clients to ensure engagement success and client satisfaction.

  Team Leadership and Development

• Lead and mentor a team of project managers, consultants, and analysts, fostering a collaborative and high-performance environment.

• Provide professional development opportunities, coaching, and feedback to build a skilled and motivated team aligned with organizational goals.

  Thought Leadership and Industry Engagement

• Stay current with healthcare industry trends, regulatory changes, and emerging technologies related to billing and enrollment .

• Contribute to the firm’s thought leadership through whitepapers, webinars, and industry presentations, positioning the firm as a leader in billing and enrollment processes to our healthcare clients.

  Travel - as needed, up to 80%

   

  Why should I join the Accenture Health team?        

• Innovate every day. Be at the forefront of designing and delivering health technology solutions that push boundaries and create new opportunities for our clients.    

• Lead with the industry’s best . Join an industry-recognized healthcare leader with more than 20,000 global healthcare professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than 200 clients to deliver healthcare transformation to meet the diverse needs of patients and members.    

• Learn and grow continuously. Harness unmatched training and professional development to help you build and advance your health, consultative and delivery skills. With learning resources, interactive classroom courses, real-life client simulations and ongoing mentoring available when you need it, you’ll expand your thinking beyond the core Workday implementation.    

  Here’s what you need:    

• Bachelor's degree in business, Accounting, Finance, Healthcare Administration, Information Systems, or related field .

• Minimum of 5 years of experience in healthcare payer operations, with a focus on enrollment and billing processes.

• Minimum of 3 years of proven experience implementing COTS health payer b illing platforms including but not limited to HealthEdge , FACETS, QNXT, and Oracle Billing and Revenue Management (ORMB) .

   

  Bonus points if you have :  

• Master's degree preferred.

• Experience working with or leading global teams. 

• Thrive in a diverse, fast paced environment. 

• Exceptional problem-solving and analytical skills.

• Excellent communication and presentation abilities.

• Leadership experience, including team management and project oversight. 

• C onfiguration experience HealthEdge , FACETS, QNXT, and Oracle Billing and Revenue Management (ORMB).

What’s in it for you?

You will be part of a diverse, vibrant, global Accenture community; teams pushing the boundaries of new business capabilities and emerging technologies and services, sharing their experiences and lessons learned with each other. You’ll have the chance to thrive in an environment where your ideas are valued and your voice matters.

At Accenture, you will be able to work on meaningful and innovative projects, powered by the latest technologies and industry best practices such as event-driven architectures and domain driven design.

Accenture will continually invest in your learning and growth. You'll learn from and work with Accenture’s certified practitioners and Accenture will support you in growing your own tech stack, sales skills, and certifications.

You'll be immersed in the design and implementation of human-centric solutions to help solve complex challenges with some of the world’s largest companies.

Compensation at Accenture varies depending on a wide array of factors, which may include but are not limited to the specific office location, role, skill set, and level of experience. As required by local law, Accenture provides a reasonable range of compensation for roles that may be hired in California, Colorado, District of Columbia, Illinois, Maryland, Minnesota, New York or Washington as set forth below.We accept applications on an on-going basis and there is no fixed deadline to apply.

Information on benefits is here. (https://www.accenture.com/us-en/careers/local/total-rewards)

Role Location Annual Salary Range

California $94,400 to $302,400

Colorado $94,400 to $261,300

District of Columbia $100,500 to $278,200

Illinois $87,400 to $261,300

Minnesota $94,400 to $261,300

Maryland $87,400 to $241,900

New York $87,400 to $302,400

Washington $100,500 to $278,200

What We Believe

We have an unwavering commitment to diversity with the aim that every one of our people has a full sense of belonging within our organization. As a business imperative, every person at Accenture has the responsibility to create and sustain an inclusive environment.

Inclusion and diversity are fundamental to our culture and core values. Our rich diversity makes us more innovative and more creative, which helps us better serve our clients and our communities. Read more here (https://www.accenture.com/us-en/about/inclusion-diversity/us-workforce)

Equal Employment Opportunity Statement

Accenture is an Equal Opportunity Employer. We believe that no one should be discriminated against because of their differences, such as age, disability, ethnicity, gender, gender identity and expression, religion or sexual orientation.

All employment decisions shall be made without regard to age, race, creed, color, religion, sex, national origin, ancestry, disability status, veteran status, sexual orientation, gender identity or expression, genetic information, marital status, citizenship status or any other basis as protected by federal, state, or local law.

Accenture is committed to providing veteran employment opportunities to our service men and women.

For details, view a copy of the Accenture Equal Employment Opportunity and Affirmative Action Policy Statement (https://www.accenture.com/content/dam/accenture/final/accenture-com/document/Annual-Policy-Statement-Regarding-EEO-2023-Applicant.pdf#zoom=50) .

Requesting An Accommodation

Accenture is committed to providing equal employment opportunities for persons with disabilities or religious observances, including reasonable accommodation when needed. If you are hired by Accenture and require accommodation to perform the essential functions of your role, you will be asked to participate in our reasonable accommodation process. Accommodations made to facilitate the recruiting process are not a guarantee of future or continued accommodations once hired.

If you would like to be considered for employment opportunities with Accenture and have accommodation needs for a disability or religious observance, please call us toll free at 1 (877) 889-9009, send us an email (https://www.accenture.com/us-en/about/contact-us) or speak with your recruiter.

Other Employment Statements

Applicants for employment in the US must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States.

Candidates who are currently employed by a client of Accenture or an affiliated Accenture business may not be eligible for consideration.

Job candidates will not be obligated to disclose sealed or expunged records of conviction or arrest as part of the hiring process.

The Company will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. Additionally, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the Company's legal duty to furnish information.