Director, Provider Data Management - Inventory Management - Remote

Molina Healthcare; Cleveland (OH); Remote; USD 97,000 - 228,000; Full time

Job summary

A leading healthcare provider is seeking a professional responsible for managing critical provider information within claims databases. The ideal candidate will have over 7 years of experience handling provider data and regulatory compliance. The role includes strategic planning and implementation of business process changes. Competitive compensation and benefits are offered.

Benefits

Competitive benefits and compensation package

Qualifications

• 7-9 years of relevant provider information management experience.
• Experience leading and managing complex business processes.
• Knowledge of regulatory requirements related to provider information.

Responsibilities

• Manage provider information process functions.
• Develop and maintain provider data in claims payment systems.
• Respond to legislative and regulatory developments akin to provider information.

Skills

Data validation

Strategic planning

Regulatory knowledge

Cross-departmental collaboration

Education

Graduate Degree or equivalent

Job description

Overview

Job Description

Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.

Responsibilities

• Strategically plans, leads, and manages the overall Provider Information process functions.
• Directs the development, implementation and maintenance of provider data in the claims payment system.
• Supports critical business strategies by providing systematic solutions and or recommendations on business processes.
• Organizational expert in responding to legislative and regulatory developments and audits as it relates to provider information. Supports others in facing out to regulators in developing and implementing appropriate Corrective Action Plans for submission of provider network files, etc.
• Engages with IT and other departments to implement changes to business processes and systems for Corporate Operations PMO.

Qualifications

• Required Education: Graduate Degree or equivalent combination of education and experience
• Required Experience: 7-9 years
• Preferred Education: Graduate Degree or equivalent combination of education and experience
• Preferred Experience: 10+ years

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

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Pay Range: $97,299 - $227,679 / ANNUAL

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.