Director, Provider Data Management - Inventory Management - Remote

Molina Healthcare; Macon (GA); Remote; USD 97,000 - 228,000; Full time

Job summary

A healthcare organization in Georgia is seeking an experienced individual to manage provider information processes. Responsibilities include maintaining data accuracy, ensuring compliance with regulations, and collaborating with IT to improve business systems. Candidates should have a graduate degree and 7-9 years of relevant experience. This position offers a competitive compensation package with a salary range of $97,299 - $227,679 per year.

Benefits

Competitive benefits package

Qualifications

• 7-9 years of experience in provider information management is required.
• Preferred candidates should have 10+ years of relevant experience.

Responsibilities

• Manage the overall Provider Information process functions.
• Develop and maintain provider data in claims systems.
• Provide recommendations for business process improvements.
• Respond to legislative developments and support audits.
• Collaborate with IT to implement changes to business processes.

Skills

Provider information management

Data synchronization

Legislative compliance

Business process improvement

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.

#PJCorp

#LI-AC1

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

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