Manager, Provider Operations – Provider Data

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist in advancing initiatives aimed at enhancing the accuracy, completeness, timeliness, and scalability of provider and facility data operations from onboarding through continuous maintenance and verification.

• Support the oversight of the operational performance of offshore teams and automated solutions that facilitate provider data and verification initiatives, including the monitoring of quality, productivity, capacity, and issue trends.

• Create and sustain reporting, dashboards, and monitoring tools that offer insights into operational performance, verification outcomes, data quality trends, emerging risks, and opportunities for intervention.

• Collaborate with product and engineering teams to articulate requirements, test enhancements, and enhance the usability, accuracy, and scalability of verification tools and workflows.

• Aid in the design, development, and supervision of AI agents and other automation solutions that boost the efficiency, scalability, and accuracy of provider data operations and initiatives.

• Investigate the root causes of persistent data issues and propose process, tooling, or upstream enhancements that prevent their recurrence.

• Collaborate with claims and other internal data teams to produce reporting and analyses that quantify the operational and business impact of provider data issues.

• Act as a versatile operational leader capable of establishing structure in ambiguous settings, addressing new problem areas, and adjusting priorities as business and member needs evolve.

⛳️ Requirements

• Bachelor's degree with 3–5+ years of relevant experience in healthcare operations, provider data, provider directory, credentialing, claims, network operations, data quality, or a related field.

• Experience in managing operational workflows related to provider data, record validation, data quality, research, verification, or issue resolution.

• Proven ability to develop, document, and scale repeatable operational processes with measurable quality and productivity outcomes.

• Strong analytical skills, including the capability to investigate data issues, recognize patterns and anomalies, and translate findings into clear operational actions.

• Experience in building or maintaining dashboards, reporting, or monitoring tools to identify risks and track performance.

• Background in partnering with product and engineering teams to establish requirements, test enhancements, and improve operational tools.

• Excellent project management, communication, and organizational skills, with the ability to prioritize competing needs and collaborate effectively with offshore teams and cross-functional partners.

• Self-motivated and comfortable working in a fast-paced, metrics-driven environment with uncertainty and shifting priorities.

• Experience in managing or scaling offshore, vendor, or shared-services teams.

• Familiarity with applying AI, agentic workflows, machine learning, or automation to minimize manual operational tasks.

• Proficiency in SQL or equivalent skills to query, join, and validate provider, claims, or operational data directly.

• Awareness of provider directory requirements, CMS Medicare Advantage directory accuracy expectations, or other healthcare data and network regulations.

🏝️ Benefits

• Employer-sponsored health, dental, and vision plan with low or no premium.

• Generous paid time off.

• $100 monthly mobile or internet stipend.

• Stock options available for all employees.

• Bonus eligibility for all roles excluding Director and above.

• Parental leave program.

• 401K program.