Senior Manager, Provider Data & Analytics

Westmont, Illinois

Senior Manager, Provider Data & Analytics Job Opening in Westmont, Illinois - Senior Manager, Provider Data & Analytics
Westmont, illinois
Req ID: 1055153
Salary: $100,000?$120,000
Job description
Position Purpose: Oversee all reporting and data requirements for the health plan, including but not be limited to such activities as: encounter reporting development and submission, network development reporting, provider data reporting and data comparisons for start up and ongoing operations, extractions for directory submissions, maintenance of data among multiple systems for integrity, operational scorecards, and other reporting and data requirements as defined by the plan
Direct oversight for Credentialing function (in partnership with QI) ensuring the process between credentialing and provider data integrity is seamless
Direct oversight of encounter error corrections, processing and reporting to meet State established acceptance rate
Responsible for all system implementations, development of business requirements, and system enhancement projects
Create, validate and produce reports for state or other reporting needs
Direct oversight and coordination of GeoAccess reports and provider network reports required for submission to the state on an ongoing basis
Coordinate with Provider Relations and Claims to address Network Data errors and claims processing issues
Develop reports to assure data integrity among multiple data sources and works with accountable departments to resolve issues
Responsible for working with the QI department in the development of QI and credentialing reports
Accountable for any ad hoc reporting needs as defined by the health plan
May oversee Provider Data department staff and activities including provider set up forms, maintenance of provider records and audit provider data records
Qualifications:
: Bachelor's degree in a related area or equivalent experience. 7+ years of experience in a similar position in a health plan or network setting. Project management, claims , and implementation experience required. Must be able to develop system business requirements.
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Employee Status:
Regular
Job Level:
Manager
Job Type:
Regular
More information about the job
Is Relocation Available?
Yes, regional
Is there a bonus structure?
15%
Are you open to sponsorship?
No
Is there a possibility to work remote?
No
Is there equity?
No
Are there flexible work hours?
No
Does this position have direct reports?
No
Who does this position report to?
Director, Operations
What are the 3-4 non-negotiable requirements on this position?
Strong operational experience. Healthcare operations management strong analytical skills
What are the nice-to-have skills?
Managed care Provider Data
What is exciting about this opportunity? Please use this section to describe team and company culture.
This division is growing very quickly and we expanding our operations extensively.
Job Type: Full-time
Salary: $100,000.00 to $120,000.00 /year
Required experience:
Clinical Data Management: 1 year
Project management, claims , and implementation: 7 years