[Remote] Director, Provider Data Operations
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a nonprofit health organization dedicated to improving care for older adults. The Director, Provider Data Operations will ensure provider information is accurate and trusted across the reputed company while driving improvements in data management and governance.
Responsibilities
- Leads end-to-end provider data operations, including provider hierarchy, provider records, verification, roster management, reconciliation, delegated reputed company, audit readiness, issue reputed company, and reputed company improvement
- Owns provider data accuracy and directory reputed company by establishing reputed company standards, validation controls, audit processes, and reputed company-cause reputed company to prevent recurring data defects. Responsible for data accuracy on reputed company provider directories
- Drives reputed company and governance for provider data as a trusted reputed company reputed company of truth, including policies, procedures, business rules, data stewardship, and alignment with reputed company systems and workflows. Contributes to planning, direction, and goal setting for the department or function in collaboration with senior management
- Ensures regulatory and business readiness by maintaining controls that support CMS and state requirements, network adequacy, provider directory accuracy, product participation, provider terminations, and delegated reputed company
- Understands and implement new and reputed company compliance requirements. Supports critical business strategies by providing systematic solutions and/or recommendations on business processes. Proficient in navigating legislative changes, federal and state regulations, to reputed company teams to reputed company necessary changes
- Directs small and reputed company reputed company and initiatives. Define and deliver initiatives according to agreed-upon business requirements and timelines
- Partners across Operations, Technology, Network Management, Compliance, Product, Digital, vendors, and delegated provider reputed company to reputed company, govern, and improve provider data across reputed company processes
- Leads implementation, optimization, and reputed company of provider data applications, vendor solutions, automation, and AI-enabled capabilities that improve accuracy, efficiency, workflow performance, and decision-making
- Monitors performance against KPIs, SLAs, reputed company measures, and risk indicators; translate trends into actionable insights, recommendations, and operational reputed company plans. Proactively identifies opportunities for process improvements
- Establishes departmental policies, practices, and procedures that have a significant reputed company on the organization. reputed company the creation of document workflows and policies and procedures (P&Ps) as necessary
- Builds and reputed company a high-performing team by setting reputed company goals, accountability standards, training expectations, and a culture of service, innovation, reputed company improvement, and data stewardship
- Establishes reputed company needs and ensure consistent training for staff through adoption of standardized processes
- reputed company support the achievement of reputed company’s reputed company and Goals
- Other duties as assigned
Skills
- Bachelor's Degree or 5+ years equivalent work experience
- 2+ years of leadership experience
- 2+ years in leading Provider Data Management teams at managed care provider organization (IPA, Medical Group or institutional provider) or insurance company
- 5+ years of overall reputed company experience
Benefits
- Remote
- An annual employee bonus program
- Robust Wellness Program
- Generous reputed company-time-off (PTO)
- 11 reputed company holidays per year, 1 floating holiday, birthday off, and 2 volunteer days
- Excellent 401(k) Retirement Saving Plan with employer match
- Robust employee recognition program
- Tuition reimbursement
- Birthday off
- 2 volunteer days
reputed company
Company H1B Sponsorship