Director Provider Data Management

Were looking for a Director of Provider Data Management someone whos ready to grow with our this position you will lead and oversee the teams and structure required to maintain provider data throughout the technical ecosystem. Includes oversight of the Provider Data Integrity (PDI) team that is responsible for reconciling monitoring and correcting provider data the Provider Set-Up Team (PSU) that establishes provider records in EPIC Tapestry and provider data staff that monitor and build interfaces with provider data and map provider information across systems. Ensure compliance with relevant state and regulatory requirements industry standards and internal policies and procedures.
Establish implement and monitor quality control measures and ensure the teams adherence to such measures. Assess workflows and processes for potential improvements and efficiencies. Work collaboratively with leaders and subordinates to evaluate and work cross functionally to implement new ideas and strategies.

Think youve got what it takes

Job Duties & Responsibilities
Lead the Provider Data Integrity (PDI) and the Provider Set-Up (PSU) Teams
Support provider data governance through the promotion of data accuracy by providing oversight of the outcomes of PDI including their continuous review monitoring and reporting of provider data including the identification of issues reports or processes that could improve accuracy or resolve discrepancies.
Lead the Provider Set-Up Team ensuring the accurate and timely establishment and continuous maintenance of provider records in Tapestry.
Allocate appropriate personnel and resources to ensure success of the function. Define staff priorities and create measures and processes to hold staff accountable to those priorities.
Oversee the operations of the function ensuring compliance with state and regulatory requirements policies and procedures and best practices. Provide training to new and existing staff and ensure staff is knowledgeable of the departmental operations policies and processes standards and solution offerings.
Establish and execute a means to provide ongoing and informative updates to staff and health plan leaders regarding industry standards and best practices.
Work with staff to identify opportunities for their professional development specifically opportunities to improve skills and growth within the department. Carry out mentoring coaching developing disciplining hiring and firing of staff.
Ensure staff are meeting developmental goals by conducting regular reviews and completing timely performance appraisals. Motivate staff by encouraging and empowering them to achieve; establish challenging performance standards; create enthusiasm a feeling of investment and a desire to excel.
Manage financial performance for approved budgets.
Regulatory Monitoring and Data Transmission
Reporting and Analysis
System Integration
Data Governance and Compliance

Skills & Requirements

Bachelors Degree Healthcare Administration Business Administration MIS Finance or related preferred
Masters Degree preferred
8 years Heath plan healthcare finance or other related data analytics experience including the management and/or processing of large volumes of data using technical skills including but not limited to SQL python Tableau QlikSense or a combination thereof required
3 years Supervisory experience including strategic planning and/or project management experience within a healthcare environment required