Sr. Manager of Provider Data Management

Optum; Pearland (TX); On-site; USD 130,000 - 170,000; Full time

Job summary

Optum is seeking a Sr. Manager of Provider Data Management in Pearland, TX to oversee daily operations across Kelsey-Seybold Clinic, KelseyCare Advantage, and PGT.

The role focuses on maintaining a unified SQL-based provider data source that supports downstream systems like claims, UM, and provider directories, ensuring data quality and regulatory compliance.

Qualifications

• 10+ years in health care or health plan roles.
• Experience with SQL servers and data management tools.
• Knowledge of CMS regulations and managed care payment methods.
• Strong written and verbal communication skills.

Responsibilities

• Oversee daily operations for provider data management across multiple entities.
• Maintain a unified SQL-based provider data source supporting downstream systems such as claims and directories.

Skills

Communication skills

SQL knowledge

Excel proficiency

Microsoft Office

CMS regulations understanding

Tools

SQL Server

Excel

Access

Microsoft Data Services

MD Staff

EPIC

Provider data management software

Job description

Primary Responsibilities:

• The Sr. Manager of Provider Data Management oversees daily operations for provider data management across Kelsey-Seybold Clinic, KelseyCare Advantage, and PGT
• Responsibilities include maintaining a unified SQL-based provider data source supporting downstream systems such as claims, UM systems, and provider directories

Required Qualifications:

• 10+ years of health care or health plan experience
• Extensive experience with SQL servers, Excel, Access, Microsoft Data Services
• Knowledge of CMS regulations and managed care payment methodologies
• Proficiency in Microsoft Office
• Excellent written and verbal communication skills

Preferred Qualifications:

• Supervisory or management experience in a managed care environment
• Experience with MD Staff, EPIC, provider data management software, SQL server
• Working Environment & Physical Demands
• Office-based environment, minimal noise
• Regular computer use and extended sitting
• Occasional walking or bending; ability to lift up to 25 lbs.