Provider Data Maintenance Team Leader

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Oversee and mentor assigned team members regarding company policies, procedures, and workflows.

• Establish objectives and implement strategies to ensure team members effectively assist providers with internal processes.

• Manage the recruitment processes for Operations personnel.

• Provide coaching to enhance individual performance and foster teamwork.

• Assess team member performance and submit performance evaluations promptly.

• Maintain expertise in assigned roles and create ongoing training and coaching programs.

• Supervise and assess data production and quality performance.

• Conduct regular one-on-one meetings with assigned staff.

• Support the Manager with staffing, training, process enhancement, and departmental budget evaluation.

• Develop and assess Operations production and data quality metrics.

• Oversee the creation and maintenance of job aids, policies, and procedures for the Provider Network.

• Coordinate with PacificSource departments to facilitate service and information exchange.

• Participate in and lead enterprise workgroups focused on provider data scalability and quality outcomes.

• Document and report pertinent communications to management, teams, and departments.

• Drive continuous improvement initiatives for enterprise and team processes.

• Cultivate a positive work environment, both virtually and in-person, offering constructive feedback and promoting ongoing learning.

• Collaborate with leadership teams to establish best practices and address enterprise-wide process challenges.

• Oversee hiring, staff development, coaching, performance evaluations, corrective measures, and terminations.

• Investigate and resolve provider data issues, escalating information when necessary.

• Ensure compliance and quality of provider data in accordance with NCQA, OHA, CMS, WAOIC, and other standards.

• Meet departmental and company performance and attendance standards.

• Adhere to PacificSource privacy policies and HIPAA confidentiality and security regulations.

• Perform additional duties as assigned.

⛳️ Requirements

• A minimum of three years of experience in a closely related insurance field or three years of supervisory experience is required.

• A high school diploma or equivalent is required.

• Strong written and verbal communication skills.

• Ability to read, comprehend, and communicate policies effectively.

• Demonstrated problem-solving skills.

• Capability to define and prioritize issues and manage workload independently.

• Ability to work under time constraints and heavy workloads.

• Utilize judgment to make logical decisions that align with company culture and philosophy.

• Proficient in general computer use, word processing, and spreadsheet applications.

• Demonstrated accountability in leadership, collaboration, communication, critical thinking, decision-making, influencing, active listening, and organizational skills.

• Ability to read and understand both written and spoken English.

• Clear and effective communication skills.

• Capability to stoop, bend, sit, and/or stand for extended durations, perform repetitive typing/sorting/filing tasks, and lift/carry files and business materials.

🏝️ Benefits

• Work from home designation (WFH: NC).

• Virtual and in-person work environment.

• Equal opportunity employment.

• Approximately 5% travel required.

• At-will employment.