Manager, Provider Data Operations

Greenwood, IN - USA

Monthly Salary: $ 103400 - 149430

Posted on: 15 hours ago

Vacancies: 1 Vacancy

Job Summary

The Manager Provider Data Operations functions as an advisor to a department function or organizational unit regarding duties responsibilities projects and/or activities. He/she is actively involved in daily operations of the Provider Data team only when required to meet schedules or resolve problems. His/her primary role is to implement and execute policies and to ensure that departmental priorities schedules and deliverables are attained. This level typically has responsibility for budgeting controlling costs planning scheduling and procedural changes. The Manager Provider Data Operations embodies Healthfirsts Culture Drivers through his/her workplace behavior while promoting and reinforcing subordinate behavior that is consistent with Healthfirsts desired culture.

Work Schedule

This position requires three days per week in office (Tues/Wed/Thurs) at either: 1101 Greenwood Blvd. Lake Mary FL. or 100 Church St. New York NY.

Duties & Responsibilities:

Manages inbound requests for Provider Operations tasks including the daily Intake of tasks received from Provider Network and ensures timely completion of those tasks with minimal re-work.
Identifies opportunities for increased efficiency whilemaintaininghigh quality standards in alignment with company goalsregulatory compliance and security requirements.
Establish clear and quantifiable policies & expectations for department Team Members related to productivity and quality of work in accordance with company goals and compliance requirements.
Maintain visibility of daily production activities including volume of work completion times and quality of outcomes through Individual and aggregate Team Performance Reporting.

Complete tasks and assignments on time and within established service level agreements.
Meet with Team Members no less than monthly to discuss team performance and address trends requiring improvement.
Recognize and reward employees for accomplishments and leverage performance improvement plans to ensure accountability as needed.
Collaborate with Stakeholders across the operations to implement process improvements across teams.
Establish individual performance goals for all team members.

Attend meetings and communicate relevant changes and updates as appropriate.
Hire coach and develop staff for advancement.
Attend to any human resource related matters within area of responsibility by collaborating with Sr. Leadership Employee Connect and HRBP
Collaborate with Operational Audit Policy & Process Documentation and Training Delivery Teams to ensure Job Aids Training Materials and available tools and reference guides are aligned with the production environment and useful to team members.
Additional duties as assigned

Minimum Qualifications:

Moderate experience working with MS Office Suite to include adding/deleting rows/columns creating simple formulas creating standardized reports and creating letters/memos.
Experience reading and interpreting data identifying trends recommending proactive solutions and effectively communicating them to senior management.
Prior experience in a management role providing team leadership of exempt and non-exempt staff including experience administering performance reviews coaching and disciplinary action as well as conducting interviews hiring employee on-boarding and terminations.

Experience evaluating risk making sound decisions and solving problems quickly and effectively.
Experience in an Operations area managing high volume and complex repetitive tasks in quality driven environment.
Experience dynamically adjusting day to day operations and effectively leveraging resources to accommodate unexpected time sensitive tasks.
Previous experience managing competing priorities with effective communication.
Associate Degree from an accredited institution or equivalent experience.

Preferred Qualifications:

Knowledge of Medicare Medicaid Commercial and Consumer insurance guidelines

Previous experience collaborating on cross-functional processes as a subject matter expert (SME)

Experience working in health care industry specific to provider operations including Provider Data Management and/or Network Management.
Proficiency in medical terminology claims workflows and claims fundamentals.
Experience with improving and automating manual processes to reduce completion time while minimizing errors eliminating rework and meeting quality expectations.
Experience in a Customer Service Environment with Internal and/or External business partners.
Experience with MS Visio and Process Mapping.
Basic understanding of Healthfirst systems such as: MHSMacessand Healthfirst Pega-Systems.
Understanding of Tableau Software Qlik Cloud HealthEdge Payer Claims or Provider Data Management Modules.

Bachelors degree from an accredited institution or equivalent experience.

Compliance & Regulatory Responsibilities: See above

License/Certification: NA

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race color creed religion sex national origin sexual orientation pregnancy age disability genetic information domestic violence victim status gender and/or gender identity or expression military status veteran status citizenship or immigration status height and weight familial status marital status or unemployment status as well as any other legally protected basis. HF Management Services LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment please contact us by sending an email to or your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services LLC will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with HF Management Services LLC.

Know Your Rights

All hiring and recruitment at Healthfirst is transacted with a valid @ email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @ or not one of our recruitment partners please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

Greater New York City Area (NY NJ CT residents): $103400 - $149430
All Other Locations (within approved locations): $88700 - $131920

As a candidate for this position your salary and related elements of compensation will be contingent upon your work experience education licenses and certifications and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary Healthfirst offers employees a full range of benefits such as medical dental and vision coverage incentive and recognition programs life insurance and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in good faith would pay to a new hire or for a job promotion or transfer into this role.

Required Experience:

Manager