Manager, Provider Data Quality

The Manager, Provider Data Quality at Point32Health is responsible for developing and overseeing the provider directory quality audit program. This role involves designing and implementing a comprehensive audit program, establishing policies and standards for provider data management, ensuring compliance with regulations, and overseeing the vendor platform for directory and attestation services.

Duties/Responsibilities

• Facilitate the development and implementation of an end-to-end process supporting provider data audits to enhance the accuracy of the Point32Health provider directories.
• Design and implement a comprehensive provider directory and data audit program for continuous improvement of provider directory quality.
• Establish policies, procedures, and standards for provider data management and audits, and roster reconciliation.
• Ensure compliance and stay informed about all relevant regulations and standards related to provider directories.
• Responsible for the enterprise provider directory & attestation platform vendor oversight and performance.
• Establish key performance indicators (KPIs) and metrics to measure the effectiveness of the provider directory and data audit program.
• Perform other duties as assigned by management.

Qualifications

• Educational Requirement: Associates, bachelor’s, or other advanced degree preferred. Equivalent work experience required.
• Experience: 5-7 years’ experience in a managed healthcare organization, proven experience in program development and team leadership.
• Skills: Strong verbal and written communication skills, advanced understanding and experience with Excel.

Salary Range: $104,612.00 - $156,918.00

Compensation & Total Rewards Overview: Point32Health offers a competitive and comprehensive total rewards package which includes medical, dental, and vision coverage, retirement plans, paid time off, employer-paid life and disability insurance, tuition program, well-being benefits, and more. For more details, visit here.

Equal Opportunity Employer: Point32Health welcomes all applicants and will consider all qualified candidates for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.