Supervisor Provider File Management

CDPHP

DeWitt (MI)

On-site

USD 62,000 - 107,000

Full time

6 days ago
Be an early applicant
Application generator

An application made for this job — a tailored resume and cover letter that speak straight to the posting.

Get past ATS filters

Job summary

CDPHP is seeking a Supervisor to lead the Provider File Management (PFM) team, ensuring accurate provider data and timely delivery within budget. The role directs training, workflow coordination, and cross-divisional collaboration, communicating requirements across stakeholders.

The incumbent will supervise PFM staff, prioritize work, analyze errors, drive process improvements, and partner with IT to implement new data management tools while upholding privacy and regulatory standards.

Qualifications

  • Directs the Provider File Management team to ensure quality and timeliness.
  • Oversees staff interviews, training, and performance coaching.
  • Leads analyses to drive process improvements and data-driven decisions.

Responsibilities

  • Supervises technical and analytical work of PFM staff.
  • Coordinates prioritization and scheduling of work assignments and projects.
  • Interacts with external customers and cross-divisional teams to communicate requirements.

Skills

Leadership
Project management
Data analysis
Stakeholder communication
Governance
Risk assessment
Problem solving
Time management

Education

Bachelor's in CS/IT
Experience in lieu of degree

Tools

Azure DevOps

Job description

Job Description:
Summary:

The incumbent directs the team responsible for maintaining the integrity and quality of the provider files. This role oversees the training, coordination of all departmental workflows, prioritization of assignments, interaction with external customers as well as effectively communicating requirements amongst various cross-divisional teams. The Supervisor effectively leads the Provider File Management (PFM) team in such a way as to ensure quality delivery within time and budget constraints.

Essential Accountabilities:
  • Supervises technical and analytical work of assigned PFM staff. Interviews, selects and trains staff to achieve or exceed established standards of performance. Monitors and coaches PFM employees.
  • Coordinates the prioritization and scheduling of work assignments and projects, including oversight of and responsibility for all provider file activity and day to day operations of the unit.
  • Initiates and leads analyses within the department to drive innovative approaches to process improvement strategies.
  • Represents Provider Network Engagement (PNE) in Azure DevOps request prioritization teams, and Maintenance of Business (MOB) work, ensures appropriate prioritization of PNE works (and provides guidance and support to justify critical nature of work).
  • Analyzes and resolves errors/trends, make appropriate corrections. Troubleshoots provider affiliation issues referred by IDNs, Customer Service, Provider Relations.
  • Acts as a resource subject matter expert for provider data management requirements.
  • Prepares reports and detailed business documents as required.
  • Ensures that projects and provider data management administration tasks meet time, cost, and quality parameters.
  • Identifies and installs quality monitoring tools and processes.
  • Drives process improvements, leverages technology effectively, collaborates across stakeholders, contributes to key meetings, and supports team development and knowledge sharing.
  • Identifies provider file/data quality trends through analysis and collaboration.
  • Interfaces with IT to implement new technology requirements.
  • Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.
  • Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
  • Maintains knowledge of all relevant legislative and regulatory mandates and ensures that all activities are in compliance with these requirements.
  • Conducts periodic staff meetings to include timely distribution and education related to departmental and Ethics/Compliance information.
  • Regular and reliable attendance is expected and required.
  • Performs other duties and functions as assigned by management.
Minimum Qualifications:
  • 3 years of relevant experience, one (1) of which are in a defined project lead and/or leadership role, required.
  • Bachelor's Degree in Computer Science, Information Technology or related. In lieu of degree, a minimum of six (6) additional years relevant experience required.
  • Demonstrated leadership and supervisory experience, prior experience supervising, managing people and/or projects, or indirectly leading teams.
  • Ability to assess risk and prioritize planned activities, analyze complex issues, and make data-driven decisions for effective solutions with stakeholders' input.
  • Demonstrated experience with project design, development, creation of metrics, and governance processes required to manage projects.
  • Knowledge of overall Health Plan operations, contract benefits, and provider databases.
  • Demonstrated expertise in structured systems analysis and design, data gathering techniques and management information systems.
  • Expertise in relevant configuration programming, job control languages and structured configuration programming techniques.
  • Strong project management and communication skills.
Physical Requirements:
  • Ability to work prolonged periods sitting and/or standing at a workstation and working on a computer.
  • Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse, and/or phone for three (3) or more hours at a time.
  • Ability to work in a home office for continuous periods of time for business continuity.
  • Ability to travel across the Health Plan service region for meetings and/or trainings as needed.
Compensation Range(s):

Grade E3: Minimum $62,400 - Maximum $106,929

The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position's minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package. Other components of the total rewards package may include participation in group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays.

Please note: There may be opportunity for remote work within all jobs posted by the CDPHP Talent Acquisition team. This decision is made on a case-by-case basis.

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Get your free, confidential resume review.
or drag and drop your file here.
Similar jobs

Similar jobs worth comparing

Supervisor Provider File Management
Supervisor Provider File Management

Capital District Physicians Health Plan Inc • Town of De Witt (NY)

On-site
USD 62,000 - 107,000
Remote work option
Supervisor Provider File Management
Supervisor Provider File Management

Capital District Physicians Health Plan Inc • City of Binghamton (NY)

On-site
USD 62,000 - 107,000
Supervisor Provider File Management
Supervisor Provider File Management

Capital District Physicians Health Plan Inc • City of Albany (NY)

Hybrid
USD 62,000 - 107,000
Supervisor Provider File Management
Supervisor Provider File Management

Capital District Physicians Health Plan Inc • City of Rochester (NY)

Hybrid
USD 62,000 - 107,000
Supervisor Provider File Management
Supervisor Provider File Management

Univera Healthcare • Buffalo (NY)

On-site
USD 62,000 - 107,000
Supervisor Provider File Management
Supervisor Provider File Management

Univera HealthСare • DeWitt (MI)

Hybrid
USD 62,000 - 107,000
Health insurance
Dental insurance
Retirement plan
+3
Supervisor Provider File Management
Supervisor Provider File Management

Univera HealthСare in • Town of De Witt (NY)

Hybrid
USD 62,000 - 107,000
Supervisor Provider File Management
Supervisor Provider File Management

Excellus BCBS • Town of De Witt (NY)

Hybrid
USD 62,000 - 107,000
Remote work possible
Supervisor Provider File Management
Supervisor Provider File Management

Excellus BCBS • City of Utica (NY)

On-site
USD 62,000 - 107,000
Remote work consideration
Supervisor Provider File Management
Supervisor Provider File Management

Excellus Health Plan Inc. in • Town of De Witt (NY)

Hybrid
USD 62,000 - 107,000