Provider Data Maintenance Team Leader

pacificsource; North Carolina; Hybrid; USD 65,000 - 95,000; Full time

Job summary

PacificSource is seeking a vigilant Operations Supervisor to lead and develop a team, ensuring effective support to providers and adherence to policies. You will guide staff, oversee data production and quality, and drive process improvements across the department.

The role emphasizes hiring, coaching, performance evaluations, and collaboration with leadership to optimize workflows and outcomes. Travel is expected around 5% as needed.

Qualifications

• Minimum of three years of experience in closely related insurance field or three years' supervisory experience required.
• Effective written and oral communication. Ability to read, understand and communicate policies.
• General computer, word processing and spreadsheet skills.

Responsibilities

• Supervise and provide guidance to assigned team members regarding company policies, procedures, and workflow.
• Set goals and implement strategies to ensure team members are effectively assisting providers with internal processes.
• Responsible for hiring process of various Operations staff.
• Demonstrate effective leadership by coaching to improve individual performance and develop teamwork.
• Evaluate team member performance.
• Oversee provider data production and quality.
• Lead continuous improvement efforts for department processes.
• Foster a positive work environment (virtually and in person).
• Work collaboratively with PacificSource leadership teams to develop best practices.

Skills

Leadership

Team collaboration

Communication

Critical thinking

Decision making

Influencing

Listening

Organization

Education

High school diploma

Job description

Looking for a way to make an impact and help people?Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.

Supervise and provide guidance to assigned team members regarding company policies, procedures, and workflow. Set goals and implement strategies to ensure team members are effectively assisting providers with internal processes. Responsible for hiring process of various Operations staff. Demonstrate effective leadership by coaching to improve individual performance and develop teamwork. Evaluate team member performance. Oversee provider data production and quality.

Essential Responsibilities:

• Maintain broad knowledge of all positions assigned to lead and develop programs to assure ongoing training and coaching to assigned staff.
• Supervise and evaluate data production and quality performance of team members. Conduct and submit performance evaluations on a timely basis.
• Conduct regular 1:1 with assigned staff
• Assist Manager in analyzing and determine staffing, training, and process improvement needs related to department goals.
• Assist manager in assessment, development, and oversight of department budget.
• Responsible for the creation, and evaluation of Operations production and data quality metrics to measure.
• Supervise creation around development and maintenance of Provider Network job aids, policies and procedures.
• Serve as liaison with all PacificSource departments to coordinate optimal provision of service and information.
• Attend and lead various enterprise workgroups related to provider data scalability and quality outcomes. Document and report any pertinent communications back to the manager, team, or department.
• Lead continuous improvement efforts for both enterprise and team processes to ensure department and company outcomes are met.
• Responsible for fostering a positive work environment (virtually and in person), offering constructive feedback and promoting continuous learning and department development goals.
• Work collaboratively with various PacificSource leadership teams to develop best practices and address issues across various enterprise wide processes.
• Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
• Investigate and settle issues with provider data as needed. Relay information for resolution to Manager, Director, appropriate departments, and personnel.
• Responsible for the oversight and compliance of provider data quality related to various regulatory and marketability standards. Including but limited to NCQA, OHA, CMS, WAOIC, etc.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

SUCCESS PROFILE

Work Experience:

Minimum of three years of experience in closely related insurance field or three years' supervisory experience required.

Education, Certificates, Licenses:

Requires high school diploma or equivalent.

Knowledge:

Effective written and oral communication. Ability to read, understand and communicate policies. Effective problem solving skills required. Requires ability to define and prioritize problems and manage workload without direct supervision. Ability to work under time pressures and heavy workloads. Ability to use judgment to make logical decisions that are consistent with company culture and philosophy. General computer, word processing and spreadsheet skills.

Competencies:

• Building Trust
• Building a Successful Team
• Aligning Performance for Success
• Building Customer Loyalty
• Building Strategic Work RelationshipsContinuous Improvement
• Decision Making
• Facilitating Change
• Leveraging Diversity
• Driving for Results

Environment:

Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.

Skills:

Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary fo