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Senior Analyst, Credentialing and Enrollment

ID da vaga JR - 152641 Localização Estados Unidos (Remote) Localizações adicionais St Paul, Minnesota Categoria de Emprego Market Access Data de publicação 12/06/2024
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This is where you save and sustain lives

At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You’ll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients. 

Baxter’s products and therapies are found in almost every hospital worldwide, in clinics and in the home. For over 85 years, we have pioneered significant medical innovations that transform healthcare.

Together, we create a place where we are happy, successful and inspire each other. This is where you can do your best work. 

Join us at the intersection of saving and sustaining lives— where your purpose accelerates our mission. 

Your Role at Baxter

THIS IS WHERE you build trust to achieve results

As the Senior Analyst, Credentialing and Enrollment, you will research and supervise all credentialing and enrollment activities and maintain the Respiratory Health payer tracking system. Ensure compliance with Commercial payers and state Medicaid program payer regulations by working cross-functionally to audit, align and update internal processes. Build in operations activities to support ongoing continuity with Commercial payers and state-specific Medicaid programs, monitor external changes to participation requirements, and remediate issues as they arise both internally and externally. The Senior Analyst, Credentialing and Enrollment should have a strong attention to detail, expertise interpreting complex regulatory standards, and the ability to operationalize policy requirements. Outstanding oral and written communication skills are also required.

  • Preferred Location-St. Paul; Office-based with Remote Consideration

  • Up to 10% Travel as Needed.

Your Team

At Baxter, our Respiratory Health division is a leader in bringing the most innovative respiratory products to patients in the home, with a focus on enhancing patients’ quality of life and mobility. Currently, we are seeking a Senior Analyst,Credentialing and Enrollment to join our growing team who is passionate about helping to deliver our state-of-the-art products to patients by facilitating credentialing and enrollment activities with Commercial payers and state Medicaid programs. 

We embrace a culture of continuous learning with a focus to drive the company’s mission forward. By actively seeking out new learning opportunities and staying curious and engaged, you can help ensure that the team remains laser focused on the quest to save and sustain lives.

We courage teamwork and collaboration and prioritize building relationships with each other. It's easy to do because we all share common traits of reliability, ethics, and caring. We lean on our colleagues for their expertise and hold each other accountable.

What You’ll Be Doing

  • Stay up to date with healthcare regulations and payer requirements.

  • Review Commercial payer requirements and state Medicaid program websites and communications (i.e., email notifications and bulletins) for participation requirements, regulation, and flexibilities/waivers; contact Commercial payers and state Medicaid agencies to confirm changes or to clarify policy changes.

  • Research, initiate, and maintain Commercial and state Medicaid program requirements, with a specific focus on enrollment and credentialing activities.

  • Serve as the primary point of contact for policies during the enrollment process in Respiratory Health.

  • Monitor States and provider enrollment applications and ensure timely approval.

  • Review credentialing and enrollment materials and other pertinent documents with utmost detail and communicate findings back to the Vice President of Reimbursement & Patient Services and General Counsel.

  • Evaluate business risks associated with Commercial payers and state Medicaid program requirements and changes.

  • Assist in auditing and quality assurance.

  • Work collaboratively with the Respiratory Health Market Access and Managed Care team on the Annual Payer Review and Quarterly Quality Reviews, as well as build out reports for the operations teams.

  • Identify opportunities for process improvement, efficiency, and accuracy.

  • Conduct regular quality reviews of Commercial and state Medicaid program payer information and revise for accuracy and clarity.

  • Facilitate cross-collaboration with internal partners and stakeholders within the Patient & Customer Services Group.

What You’ll Bring

  • Bachelor’s degree or equivalent experience in related field.

  • 2+ of experience in healthcare related field with emphasis in enrollment, credentialing, billing support, and health payer policies preferred. 

  • Customer Service experience dealing with payers, specifically Commercial payer contracts and state Medicaid programs.

  • Technical savvy navigating and submitting documentation through various payer portals.

  • Knowledge of durable medical equipment and respiratory health products preferred, but not required.

  • Demonstrated success in communicating and presenting to diverse senior level executives and legal counterparts.

  • Ability to build strong partnerships at all levels.

  • Strong Team Player.

  • Computer Experience with Windows, and Microsoft Office.

We understand compensation is an important factor as you consider the next step in your career.  At Baxter, we are committed to equitable pay for all our employees, and we strive to be more transparent with our pay practices.  To that end, this position has a base salary range of $96,000 to $132,000 plus an annual incentive bonus. The above range represents the expected base salary range for this position.  The actual salary may vary based upon several factors including, but not limited to, relevant skills/experience, time in the role, business line, and geographic/office location.

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment visa at this time.

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Equal Employment Opportunity

Baxter is an equal opportunity employer. Baxter evaluates qualified applicants without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, protected veteran status, disability/handicap status or any other legally protected characteristic.

EEO is the Law 
EEO is the law - Poster Supplement
Pay Transparency Policy

Reasonable Accommodations

Baxter is committed to working with and providing reasonable accommodations to individuals with disabilities globally. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application or interview process, please click on the link here and let us know the nature of your request along with your contact information.

Recruitment Fraud Notice

Baxter has discovered incidents of employment scams, where fraudulent parties pose as Baxter employees, recruiters, or other agents, and engage with online job seekers in an attempt to steal personal and/or financial information. To learn how you can protect yourself, review our Recruitment Fraud Notice.


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