Lead, Provider File Management & Data Quality

Capital District Physicians Health Plan Inc; City of Rochester (NY); Hybrid; USD 62,000 - 107,000; Full time

Job summary

Capital District Physicians Health Plan Inc seeks a Supervisor to lead the Provider File Management (PFM) team, directing training, workflows, and cross-divisional collaboration to ensure quality deliverables within time and budget. The role requires 3 years of relevant experience with leadership, a CS/IT degree, and strong project management, governance, and data-analysis skills.

Remote work may be possible on a case-by-case basis, with interaction across IT, QA, and external partners to

Qualifications

• 3 years of relevant experience with at least 1 year in a defined leadership role
• Bachelor's Degree in Computer Science, Information Technology or related field (or six additional years of relevant experience)
• Proven leadership and supervisory experience managing people and/or projects
• Ability to assess risk, prioritize activities, and make data-driven decisions with stakeholders' input
• Experience with project design, metrics creation, and governance processes
• Knowledge of Health Plan operations, contract benefits, and provider databases
• Expertise in structured systems analysis, data gathering techniques and MIS
• Strong project management and communication skills

Responsibilities

• Supervises and develops PFM staff, including interviewing, selection, and training
• Coordinates prioritization and scheduling of provider file work and unit operations
• Leads analyses to drive process improvements
• Represents PNE in Azure DevOps prioritization and MOB work
• Maintains provider data quality and resolves errors/trends
• Prepares reports and ensures projects meet time, cost, and quality targets
• Interfaces with IT to implement new technology requirements
• Maintains privacy and compliance with regulatory mandates

Skills

Leadership

Project management

Communication

Risk assessment

Data-driven decisions

Governance processes

Education

Bachelor's Degree in Computer Science or Information Technology

Tools

Azure DevOps

Job description

Capital District Physicians Health Plan Inc seeks a Supervisor to lead the Provider File Management (PFM) team, directing training, workflows, and cross-divisional collaboration to ensure quality deliverables within time and budget. The role requires 3 years of relevant experience with leadership, a CS/IT degree, and strong project management, governance, and data-analysis skills.

Remote work may be possible on a case-by-case basis, with interaction across IT, QA, and external partners to