[Hiring] Provider Data Maintenance Team Leader @PacificSource Health Plans

Role Description

Supervise and provide guidance to assigned team members regarding company policies, procedures, and workflow. Set goals and implement strategies to ensure team members are effectively assisting providers with internal processes. Responsible for hiring process of various Operations staff. Demonstrate effective leadership by coaching to improve individual performance and develop teamwork. Evaluate team member performance. Oversee provider data production and quality.

• Maintain broad knowledge of all positions assigned to lead and develop programs to assure ongoing training and coaching to assigned staff.
• Supervise and evaluate data production and quality performance of team members. Conduct and submit performance evaluations on a timely basis.
• Conduct regular 1:1 with assigned staff.
• Assist Manager in analyzing and determining staffing, training, and process improvement needs related to department goals.
• Assist manager in assessment, development, and oversight of department budget.
• Responsible for the creation and evaluation of Operations production and data quality metrics to measure.
• Supervise creation around development and maintenance of Provider Network job aids, policies, and procedures.
• Serve as liaison with all PacificSource departments to coordinate optimal provision of service and information.
• Attend and lead various enterprise workgroups related to provider data scalability and quality outcomes. Document and report any pertinent communications back to the manager, team, or department.
• Lead continuous improvement efforts for both enterprise and team processes to ensure department and company outcomes are met.
• Responsible for fostering a positive work environment (virtually and in person), offering constructive feedback and promoting continuous learning and department development goals.
• Work collaboratively with various PacificSource leadership teams to develop best practices and address issues across various enterprise-wide processes.
• Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
• Investigate and settle issues with provider data as needed. Relay information for resolution to Manager, Director, appropriate departments, and personnel.
• Responsible for the oversight and compliance of provider data quality related to various regulatory and marketability standards, including but not limited to NCQA, OHA, CMS, WAOIC, etc.

Qualifications

• Minimum of three years of experience in closely related insurance field or three years’ supervisory experience required.
• Requires high school diploma or equivalent.

Requirements

• Effective written and oral communication.
• Ability to read, understand, and communicate policies.
• Effective problem-solving skills required.
• Requires 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 that are consistent with company culture and philosophy.
• General computer, word processing, and spreadsheet skills.

Benefits

• Base Range: $56,779.86 - $96,525.75

Company Description

• We are committed to doing the right thing.
• We are one team working toward a common goal.
• We are each responsible for customer service.
• We practice open communication at all levels of the company to foster individual, team, and company growth.
• We actively participate in efforts to improve our many communities-internally and externally.
• We actively work to advance social justice, equity, diversity, and inclusion in our workplace, the healthcare system, and community.
• We encourage creativity, innovation, and the pursuit of excellence.