Provider Data Maintenance Team Leader

Job not on LinkedIn

🔥 0 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $56.8k - $96.5k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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 Health Plans

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

PacificSource Health Plans is a healthcare provider that offers a range of health insurance solutions, including plans for individuals, families, and employers. Their offerings include Medicare and Medicaid plans, dental coverage, and administrative services for small and large groups. Committed to member care, PacificSource emphasizes customer service and provides various resources for health management, including mental health support and wellness programs.

📋 Description

• Supervise and guide assigned team members on 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 submit 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-to-one meetings with assigned staff • Assist the Manager with staffing, training, process improvement, and department budget assessment • 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 relevant communications to management, teams, and departments • 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 • Oversee hiring, staff development, coaching, performance reviews, corrective actions, and terminations • Investigate and resolve provider data issues, escalating information as needed • Oversee compliance and quality of provider data related to NCQA, OHA, CMS, WAOIC, and other standards • Meet department and company performance and attendance expectations • Follow PacificSource privacy policy and HIPAA confidentiality and security requirements • Perform other duties as assigned

🎯 Requirements

• Minimum of three years of experience in a closely related insurance field or three years of supervisory experience required • High school diploma or equivalent required • 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, organizational skills/planning and organization • 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/carry files and business materials

🏖️ Benefits

• Work from home designation (WFH: NC) • Virtual and in-person work environment • Equal opportunity employment • Approximately 5% travel • At-will employment