Manager, Provider Data Services
Job Description:
• Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid Provider data within Aetna QNXT.
• Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc.
• Coordinates provider status information with member services and other internal departments.
• Monitor Provider Data pends and keep inventory within KPIs and/or Metrics.
• Recruits, develops, and motivates staff.
• Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions.
• Monitors staff performance, including weekly staff metrics.
Requirements:
• 3+ years recent and related experience in Provider Operations, Provider Relations or Network operations.
• 1+ years of experience in Medicaid and/or Medicare provider operations.
• 2+ years of experience with ensuring the provider data entered into the provider database is accurate and the provider documentation is complete and accurate.
• 3+ years of experience in managing, coaching, and leading a team.
• 3+ years of experience supervising or managing a production-oriented team.
• Preferred Qualifications: Strong collaboration skills, Medicaid new state or expansion experience, strong reporting and data analysis skills and experience, ability to load balance and prioritize work to meet key performance metrics around TAT and quality, drive and oversee productivity of staff, experience with new Medicaid state implementation related to provider requirements, leadership skills including staff development, critical thinking and problem-solving skills, familiarity with Provider Data/Enterprise systems, strong skills in Microsoft products, QuickBase knowledge.
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for wellness screenings
• Tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
• Many other benefits depending on eligibility
Apply Now
Apply Now
• Lead a team of Medicaid Provider Data Services Analyst responsible for loading and maintaining Medicaid Provider data within Aetna QNXT.
• Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc.
• Coordinates provider status information with member services and other internal departments.
• Monitor Provider Data pends and keep inventory within KPIs and/or Metrics.
• Recruits, develops, and motivates staff.
• Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions.
• Monitors staff performance, including weekly staff metrics.
Requirements:
• 3+ years recent and related experience in Provider Operations, Provider Relations or Network operations.
• 1+ years of experience in Medicaid and/or Medicare provider operations.
• 2+ years of experience with ensuring the provider data entered into the provider database is accurate and the provider documentation is complete and accurate.
• 3+ years of experience in managing, coaching, and leading a team.
• 3+ years of experience supervising or managing a production-oriented team.
• Preferred Qualifications: Strong collaboration skills, Medicaid new state or expansion experience, strong reporting and data analysis skills and experience, ability to load balance and prioritize work to meet key performance metrics around TAT and quality, drive and oversee productivity of staff, experience with new Medicaid state implementation related to provider requirements, leadership skills including staff development, critical thinking and problem-solving skills, familiarity with Provider Data/Enterprise systems, strong skills in Microsoft products, QuickBase knowledge.
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for wellness screenings
• Tobacco cessation and weight management programs
• Confidential counseling and financial coaching
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access
• Many other benefits depending on eligibility
Apply Now
Apply Now