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Supervisor, Provider Data Management

Smyrna, Georgia Apply Now Job ID 1152286 Category Provider Data Management Organization Peach State Health Plan Schedule Full-time
Description:
Position Purpose: Manage the daily operations of all provider data management functions. Direct provider data management related activities based on plan and contract specifications and standard business rules – includes data analysis and entry, review of data via internet sites and other systems, usage of multiple systems and applications to validate data is complete and accurate, and investigation and resolution of data issues.

  • Manage the end-to-end provider data entry and maintenance to ensure accurate and timely setup for claims payment, member assignment and directory display
  • Investigate and resolve complex provider data management issues
  • Identify trends and recommend improvements to mitigate potential issues
  • Lead task assignment for team’s workflow and distribution
  • Monitor team performance to ensure established and provider data quality benchmarks are met
  • Facilitate meetings with Health Plan representatives
  • Train and mentor Provider Data Management Analyst I, II, and Team Leads
  • Qualifications:

    Education/Experience: Bachelor’s degree in related field or equivalent experience. 3+ years of combined management and provider data management, data analysis, and customer service experience preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience in a managed care, insurance, or medical office environment. Experience performing and leading teams performing data analysis in Excel or similar tools strongly preferred.

    Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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