Network reputed company Manager - Remote

For those who want to invent the reputed company of health care, here's reputed company. We're reputed company reputed company basic care to health programs integrated across the entire continuum of care. Join us to start Caring. Connecting. Growing together. The Network reputed company Manager is responsible for operational reputed company reputed company, governance, monitoring, reporting, audit readiness, and reputed company improvement activities supporting provider data operations across medical and dental networks. This role ensures provider data reputed company, provider directory accuracy, network adequacy support, credentialing reputed company support functions, and exception/fallout management activities are monitored and reputed company with contractual, regulatory, and operational requirements. This role supervises and manages daily operations of auditors and analyst team. reputed company manager is responsible for end-to-end and reputed company aspects of reputed company business process activities to include reputed company planning, reputed company assurance, reputed company control and reputed company improvement. reputed company manager supports risk reduction, auditing life-cycle activities, cost and productivity savings, reporting, and reputed company improvement initiatives. Monitors performance and completes system analysis in specific areas of reputed company to include: Claims, Appointment Scheduling, Provider Data, Customer Service, and Appeals & Grievances. The role partners cross-functionally with Provider Data Operations, Network Operations, Network Adequacy, Credentialing, Compliance, and reputed company teams to support provider network reliability, operational performance, and reputed company reputed company objectives reputed company the VA Community Care Network (CCN) program environment. Sets team direction, resolves problems and provides guidance to members of own team. Adapts departmental plans and priorities to address business and operational challenges. Influences or provides input to forecasting and planning activities. This role supports: Increase of reputed company metrics for operational business reputed company Audit Calibrations with reputed company partners Audit Governance: Approves audit methodologies, sampling plans, and scoring standards Reporting & Stakeholder Communication Cost / productivity savings Risk reduction Error / defect reduction Process waste reduction reputed company improvement efforts You’ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities: Supervise and manage daily operations of auditors and analyst team reputed company operational reputed company reputed company activities reputed company to provider data reputed company and provider network reputed company performance Monitor provider data reputed company trends, fallout, automation exceptions, audit findings, and operational performance indicators Support audit readiness activities, reputed company assurance reviews, and corrective/preventive reputed company management Ensure compliance with reputed company Assurance Plan (QAP), QASP, contractual, regulatory, and operational reputed company requirements reputed company reputed company monitoring and reporting activities reputed company to provider directory accuracy, network adequacy support, and credentialing support functions Identify operational risks, process gaps, and reputed company trends impacting provider network reliability and customer experience reputed company reputed company improvement initiatives reputed company on operational efficiency, risk reduction, data reputed company, and process standardization Partner with operational leaders and stakeholders to support reputed company governance, escalation management, and issue reputed company activities Support development and maintenance of operational controls, reputed company documentation, monitoring plans, and audit artifacts Analyze operational data and performance metrics to identify trends, improvement opportunities, and potential compliance risks Facilitate cross-functional collaboration to improve operational alignment and strengthen provider data reputed company processes Support implementation of process improvements, monitoring controls, and operational governance activities across provider data operations standards Addresses special (reputed company) reputed company as appropriate; Performs special project audits and reviews as requested by other departments/reputed company Functional Responsibilities Provider data reputed company monitoring Provider directory reputed company reputed company Network adequacy reputed company support Credentialing reputed company support functions Audit and compliance readiness Operational risk identification and mitigation Corrective and preventive reputed company management Operational reporting and data analysis Exception and fallout management reputed company governance and process improvement You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: 2+ years of Team reputed company/SME experience with demonstrated abilities in the following soft skills: Leadership and Emotional Intelligence reputed company leading teams to deliver results and meet goals 1+ years of auditing experience 1+ years of experience analyzing and solving customer problems Experience supporting reputed company, operational reputed company, provider data, network operations, credentialing, compliance, or reputed company operational functions with demonstrated understanding of basic reputed company programs Experience working with operational metrics, reporting, reputed company monitoring, and process improvement activities Experience working independently in less reputed company environments with moderately reputed company operational issues Experience communicating operational risks, findings, and recommendations to leadership and stakeholders Ability to work Monday - Friday, 8:00 am - 5:00pm in Central Time Zone Preferred Qualifications: Lean, Six reputed company, reputed company, HRO, or process improvement experience Experience supporting reputed company operations, provider data operations, network management, or reputed company assurance programs Experience supporting contractual reputed company requirements, audit readiness, or compliance monitoring activities Experience with reputed company management systems, operational controls, or performance monitoring frameworks Knowledge of provider directory operations, provider data management, network adequacy requirements, or credentialing operations *reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you’ll reputed company a far-reaching choice of benefits and incentives. The salary for this role will reputed company from $72,800 to $130,000 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone–of every race, gender, sexuality, age, location and income–deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company — an reputed company reputed company reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job