Provider Data Maintenance Team Leader

Job not on LinkedIn

🔥 2 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $56.8k - $96.5k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 20%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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PACIFICSOURCE

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

Not-for-profit health plans

📋 Description

• Supervise and guide assigned team members regarding company policies, procedures, and workflow • Set goals and implement strategies to ensure team members effectively assist providers with internal processes • Manage hiring processes for Operations staff • Coach employees to improve individual performance and develop teamwork • Evaluate team member performance and conduct timely performance evaluations • Maintain knowledge of assigned positions and develop ongoing training and coaching programs • Supervise and evaluate data production and quality performance • Conduct regular one-on-one meetings with assigned staff • Assist the Manager with staffing, training, process improvement, and department budget needs • Create and evaluate Operations production and data quality metrics • Supervise development and maintenance of Provider Network job aids, policies, and procedures • Liaise with PacificSource departments to coordinate service and information • Attend and lead enterprise workgroups related to provider data scalability and quality outcomes • Document and report pertinent communications to the manager, team, or department • Lead continuous improvement efforts for enterprise and team processes • Foster a positive virtual and in-person work environment, provide constructive feedback, and promote continuous learning • Collaborate with leadership teams to develop best practices and address enterprise-wide process issues • Handle hiring, staff development, coaching, performance reviews, corrective actions, and employee terminations • Investigate and resolve provider data issues, escalating information as needed • Oversee compliance of provider data quality with regulatory and marketability standards, including NCQA, OHA, CMS, and WAOIC • Perform other duties as assigned

🎯 Requirements

• Minimum of three years of experience in a closely related insurance field or three years of supervisory experience • High school diploma or equivalent • Effective written and oral communication • Ability to read, understand, and communicate policies • Effective problem-solving skills • Ability to define and prioritize problems and manage workload without direct supervision • Ability to work under time pressures and heavy workloads • Ability to use judgment to make logical decisions consistent with company culture and philosophy • General computer, word processing, and spreadsheet skills • Accountable leadership, collaboration, communication, critical thinking, decision making, influencing, active listening, and organizational/planning skills • Meet department and company performance and attendance expectations • Follow PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information • Ability to read and comprehend both written and spoken English • Ability to communicate clearly and effectively • Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing/sorting/filing motions, and lift and carry files and business materials

🏖️ Benefits

• Work-from-home arrangement indicated by the location field (WFH: NC) • Equal opportunity employment • Ergonomically configured equipment • Approximately 5% travel