Provider Data Maintenance Team Leader

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

📋 Description

• Oversee and direct assigned team members in accordance with company policies, procedures, and workflow.

• Establish objectives and execute strategies to ensure team members effectively support providers with internal processes.

• Manage the hiring processes for Operations personnel.

• Mentor employees to enhance individual performance and foster teamwork.

• Assess team member performance and conduct timely evaluations.

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

• Supervise and assess data production and quality performance.

• Hold regular one-on-one meetings with assigned staff members.

• Support the Manager with staffing, training, process enhancements, and departmental budget requirements.

• Develop and assess Operations production and data quality metrics.

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

• Collaborate with PacificSource departments to coordinate services and information.

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

• Document and relay essential communications to the manager, team, or department.

• Drive continuous improvement initiatives for enterprise and team processes.

• Cultivate a positive virtual and in-person work culture, offering constructive feedback and encouraging ongoing learning.

• Partner with leadership teams to formulate best practices and address company-wide process challenges.

• Manage hiring, staff development, coaching, performance reviews, corrective actions, and employee terminations.

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

• Ensure compliance with provider data quality standards, including regulatory and marketability requirements from NCQA, OHA, CMS, and WAOIC.

• Perform additional duties as assigned.

⛳️ Requirements

• At least three years of experience in a closely related insurance field or three years of supervisory experience.

• High school diploma or equivalent required.

• Strong written and verbal communication skills.

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

• Proficient problem-solving abilities.

• Capable of identifying and prioritizing issues while managing workload independently.

• Ability to thrive under time constraints and heavy workloads.

• Exercising judgment to make logical decisions aligned with company culture and philosophy.

• General proficiency in computer usage, word processing, and spreadsheet applications.

• Skills in accountable leadership, collaboration, communication, critical thinking, decision-making, influencing, active listening, and planning/organizational tasks.

• Meet departmental and company performance and attendance standards.

• Adhere to PacificSource privacy policies and HIPAA regulations regarding confidentiality and security of protected health information.

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

• Communicate clearly and effectively.

• Capable of stooping, bending, sitting, and/or standing for extended durations, performing repetitive typing/sorting/filing actions, and lifting and carrying files and business materials.

🏝️ Benefits

• Work-from-home arrangement as indicated by the location field (WFH: NC).

• Equal opportunity employment.

• Ergonomically designed equipment.

• Approximately 5% travel required.