Director, Provider Data Management - Inventory Management - Remote

Molina Healthcare; Miami (FL); Remote; USD 97,000 - 228,000; Full time

Job summary

A healthcare provider in Miami is seeking a professional to manage the Provider Information process functions. This role requires strategic planning, regulatory compliance, and data validation skills. Candidates should possess a graduate degree and 7-9 years of relevant experience in provider management. The position offers a competitive benefits and compensation package.

Qualifications

• Graduate Degree or equivalent combination of education and experience.
• 7-9 years of relevant experience required.
• 10+ years of preferred experience.

Responsibilities

• Plans and manages Provider Information process functions.
• Directs development and maintenance of provider data.
• Provides recommendations on business processes.
• Responds to legislative and regulatory developments.
• Engages with IT for business process changes.

Skills

Provider Information Management

Data Validation

Business Process Improvement

Regulatory Compliance

Education

Graduate Degree or equivalent combination of education and experience

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.