Provider Data Manager

Centivo; Buffalo (NY); Remote; USD 60,000 - 100,000; Full time

Job summary

An innovative health plan seeks a Provider Data Manager to oversee the provider data team and ensure accuracy and compliance. This role involves collaborating with cross-functional teams, analyzing performance metrics, and enhancing data management processes. Join a forward-thinking company dedicated to improving healthcare affordability and quality for millions. With a focus on provider data management, you will play a pivotal role in optimizing operations and ensuring compliance with industry regulations. If you are passionate about healthcare and data management, this is an exciting opportunity to make a significant impact.

Qualifications

• 5+ years of experience in provider data management or healthcare operations.
• Strong understanding of healthcare regulations and compliance.

Responsibilities

• Ensure accuracy and integrity of provider data in systems.
• Analyze key performance indicators for process improvement.

Skills

Healthcare Provider Data Management

Analytical Skills

Problem-Solving

Attention to Detail

Interpersonal Skills

Knowledge of HIPAA and NCQA

Process Improvement

Education

Associate's Degree in Healthcare Administration

Bachelor's Degree (Preferred)

Tools

Provider Data Management Systems

Job description

We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

The Provider Data Manager, will play a crucial role in overseeing the day-to-day activities of our provider data team, ensuring accuracy, efficiency, and adherence to quality standards. You will report directly to the Director of Provider Data Management and collaborate closely with cross-functional teams to enhance our provider data processes.

Responsibilities Include:

• Ensure the accuracy, completeness, and integrity of provider data within our systems, making certain that all provider information is up-to-date and compliant with industry regulations.

• Collaborate with the Director of Provider Data Management to establish team goals, strategies, and performance metrics.

• Monitor and manage daily provider data operational activities.

• Resolve escalated issues from team members and internal/external stakeholders related to provider data discrepancies, ensuring timely resolution.

• Analyze and report on key performance indicators, identifying trends and opportunities for process improvement.

• Develop and maintain strong working relationships with provider network teams, credentialing teams, and other business units to drive efficient data management processes.

• Participate in the development and implementation of training programs for team members to enhance their skills and knowledge.

• Contribute to the development and optimization of provider data management workflows and technologies.

• Stay informed about industry trends, regulatory changes, and best practices in provider data management to ensure compliance and competitiveness.

Qualifications:

Required Skills and Abilities:

• Strong understanding of healthcare provider data, including provider demographics, contract details, credentialing processes, and network participation.

• Proficiency in using provider data management systems and software.

• Excellent analytical, problem-solving, and decision-making skills.

• Exceptional attention to detail and accuracy.

• Excellent interpersonal and communication skills, with the ability to collaborate effectively across departments and with external partners.

• Knowledge of healthcare regulations and compliance related to provider data management (HIPAA, NCQA, etc.).

• Proven track record of process improvement and optimizing operational efficiency.

• Ability to adapt to a fast-paced and evolving environment.

Education and Experience:

• Associate’s degree in Healthcare Administration, Business Administration, Information Management, or related field OR equivalent experience.

• Minimum of 5 years of experience in provider data management, healthcare operations, or relate roles.

Preferred Qualifications:

• Bachelor’s degree preferred

Work Location:

• This position is remote

Who we are:

Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.

Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.