Manager of Provider Data Management

Position Overview

The Manager of Provider Data Management is responsible for managing the Provider Maintenance team and related service functions.

Scope of Role & Responsibilities

• Manage special projects for the Provider Maintenance Department
• Represent Provider Maintenance in cross-departmental meetings and projects
• Manage contract review and provider record setup
• Aid staff to resolve issues in a timely manner and provide guidance so the staff can resolve similar issues without assistance
• Work closely with CORE, Contracting, Credentialing, Finance, UM and Claims to ensure providers are setup to be reimbursed accurately
• Oversee Provider Maintenance daily inventory, distribute special assignments to staff
• Manage CPI tickets assigned to Provider Maintenance
• Manage staff performance audits with provider/vendor record setup
• Work with staff in meeting personal and career development objectives

Required Education, Training & Professional Experience

• Bachelor’s Degree in health care administration or equivalent work experience
• Minimum of 5 years managed care experience including three years in a managerial capacity

Professional Competencies

• Integrity and Trust
• Customer Focus
• Proficiency in computer applications including Microsoft word and Excel
• Excellent oral and written communication skills
• Excellent organizational and analytical skills