Supervisor – Provider File Management

This is a fully remote position, open to applicants in New York.

📋 Description

• Lead the team responsible for ensuring the integrity and quality of provider files.

• Oversee the technical and analytical tasks of the assigned Provider File Management staff.

• Conduct interviews, select, train, monitor, and mentor staff members.

• Coordinate the prioritization and scheduling of assignments and projects.

• Supervise provider file activities and daily operations of the unit.

• Drive departmental analyses and strategies for process improvement.

• Represent Provider Network Engagement in Azure DevOps request prioritization teams and Maintenance of Business initiatives.

• Analyze and resolve errors and trends, correcting provider affiliation issues.

• Act as a subject matter expert for provider data management requirements.

• Generate reports and detailed business documentation.

• Ensure that projects and provider data management tasks adhere to time, cost, and quality standards.

• Identify and implement tools and processes for quality monitoring.

• Propel process improvements and collaborate with various stakeholders.

• Detect trends in provider file/data quality through analysis.

• Work with IT to establish new technology requirements.

• Ensure compliance with privacy policies, legislative and regulatory mandates, and corporate values.

• Hold regular staff meetings and disseminate departmental and Ethics/Compliance information.

• Maintain consistent and reliable attendance.

• Execute other duties as assigned.

⛳️ Requirements

• Minimum of 3 years of relevant experience required.

• At least one year of relevant experience in a defined project lead and/or leadership role required.

• Bachelor’s Degree in Computer Science, Information Technology, or a related field; alternatively, an additional six years of relevant experience may be considered in lieu of a degree.

• Proven leadership and supervisory experience, including managing people and/or projects or indirectly leading teams.

• Ability to evaluate risk, prioritize activities, analyze complex issues, and make data-driven decisions with input from stakeholders.

• Experience in project design, development, metrics creation, and governance processes.

• Knowledge of Health Plan operations, contract benefits, and provider databases.

• Proficiency 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.

• Capability to work for extended periods at a workstation and computer.

• Ability to work from a home office for extended durations to ensure business continuity.

• Willingness to travel across the Health Plan service region for meetings and/or training as required.

🏝️ Benefits

• Group health and/or dental insurance.

• Retirement plan.

• Wellness program.

• Paid time off.

• Paid holidays.

• Opportunity for remote work, evaluated on a case-by-case basis.