Hybrid Provider Maintenance & Operations Supervisor

MetroPlusHealth; New York (NY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

MetroPlusHealth in New York, NY seeks a Provider Maintenance Supervisor to oversee daily staff activities and ensure accurate provider data management. You will collaborate with Claims, Provider Network Operations, UM, IT, Credentialing, and Provider Contracting while resolving escalated issues and improving processes.

The role requires a Bachelor’s degree and at least 2 years of supervisory experience, with preferred knowledge of HRP and MS Office applications.

Qualifications

• Bachelor’s Degree required.
• Minimum 2 years’ relevant supervisory experience required; or an equivalent combination of education, training and experience.
• Knowledge of HRP (Health Rules Payor) preferred.
• Familiarity with Word, Excel and Access preferred.

Responsibilities

• Supervise staff and provide day-to-day oversight of Provider Maintenance functions.
• Document departmental policies and procedures; create/modify user manuals.
• Monitor staff performance and conduct performance reviews.
• Assist in resolving escalated provider participation issues with leadership.
• Collaborate with Core Systems and Claims teams to update provider information and reflect changes.
• Plan and implement procedures to maximize operating efficiency.
• Address inquiries from multiple departments and external customers.
• Assist in 1099 reporting and in MedHome/Uploads/Communication Grid updates.

Skills

Supervisory experience

Integrity and Trust

Customer Focus

Technical skills

Excellent communication

Analytical

Education

Bachelor's degree

Tools

Microsoft Word

Microsoft Excel

Microsoft Access

Job description

MetroPlusHealth in New York, NY seeks a Provider Maintenance Supervisor to oversee daily staff activities and ensure accurate provider data management. You will collaborate with Claims, Provider Network Operations, UM, IT, Credentialing, and Provider Contracting while resolving escalated issues and improving processes.

The role requires a Bachelor’s degree and at least 2 years of supervisory experience, with preferred knowledge of HRP and MS Office applications.