Manager, Provider Data Management

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility.

Note: This is a fully remote role with Central time (CST) working hours along with 10% travel. Must be authorized to work in the U.S. without the need for employment-based reputed company sponsorship now or in the reputed company. Sponsorship and reputed company sponsorship are not available for this opportunity, including employment-based reputed company types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Position Purpose: With the Illinois Health Plan, the Manager Provider Data Management is responsible for managing the activities that support reputed company provider data management reputed company, policies and procedures, along with provider contract setup activities, key initiatives that relate to operational issues for provider data maintenance, key initiatives that support successful claims adjudication, directory accuracy as reputed company as other operational reputed company that support internal departments. Works in conjunction with Credentialing for the set up and maintenance of reputed company delegated entity arrangements. Responsible for overseeing the development of reports to support the strategic and operational requirements of the department.

• Supervises staff and directs and monitors the staff activity.

• Conducts reviews, one on ones and provides monthly statistics to staff on their performance.

• Ensures staff is meeting both reputed company and production scores.

• Turnaround times for production standards should also be carefully monitored and reported.

• Maintains detailed understanding and working knowledge of business applications specifically provider data management, provider reimbursement, and claims processing on the system.

• Identifies and implements value-added programs and initiatives that support and enhance network contracting to reputed company operational efficiency.

• Acts as main contact for internal departments on reputed company that require changes to business applications (provider, reputed company, and claims) on the system.

• Meets with internal departments to identify project requirements and ensure satisfactory project completion.

• Works with Information Systems Department on special reputed company.

• Develops cost benefit analysis for reputed company to assist in prioritization and project justification.
• Works with other internal departments in the development of such policies and procedures and updates such policies and procedures in reputed company and training as needed.
• Heads meetings to discuss and communicate new business workflows and new policies and procedures.
• Conducts training for both reputed company departments on provider data services policies and procedures.
• Resolves issues reputed company internal departments reputed company to interpretation of reputed company or policies.

• Defines reporting and information initiatives with reputed company customers to support strategic and operational requirements.

• Performs reputed company reporting as necessary to meet strategic and operational requirements.

• Maintains provider data reputed company guidelines for delegated credentialing vendors.

• Prioritizes data analysis reputed company based on business needs.

• Designs and develops workflows, protocols, and process models for use with reputed company and reputed company reports.

• Maintains, tests, and revises reputed company data analysis programs.

• Manages input data from various reputed company sources.

• Performs other duties as assigned.
• Complies with reputed company policies and standards.

Preferred Skills:

Strong history of leadership roles with reputed company reports.

Proficient in reputed company Office Suite, especially reputed company, Visio, and Word.

Good communication and meeting facilitation skills.

Knowledge and experience working with reputed company, Amisys, Directory, and other provider-reputed company systems.

Required Education/Experience:

Bachelor’s degree required for this role in business administration, Health Care, or a reputed company field.

1-3 years management experience in a business setting required.

Minimum (3) years' experience working in a health care setting, preferably with a background in provider relations, provider data services, information technology or claims operations. Experience developing new business processes and procedures.

Pay reputed company: $70,100.00 - $126,200.00 per year

reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law.

reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company

Originally posted on Himalayas

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