Manager – Medicaid Provider Data Services
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Massachusetts • Missouri • United States
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Salary
💰 $54,300 - $145,860 per year
About the role
- Lead a team of Medicaid Provider Data Services Analysts responsible for loading and maintaining Medicaid Provider data within Aetna QNXT
- Team will also include provider operations analyst and potential pre-cred support for implementation activities
- Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc
- Coordinates provider status information with member services and other internal departments
- Recruits, develops, and motivates staff
- Initiates and communicates a variety of personnel actions including, employment, termination, performance reviews, salary reviews, and disciplinary actions
- Monitors staff performance, including weekly staff metrics; coaches and mentors’ staff on performance issues or concerns
Requirements
- 3+ years of recent and related experience in Provider Operations, Provider Relations, or Network operations
- 1+ years of experience in Medicaid provider operations
- At least 1 year of experience with ensuring the provider data entered into the provider database is accurate and the provider documentation is complete and accurate
- 1+ years of experience in managing, coaching, and leading a team of Provider Data Services Analysts
- At least 1 years of experience leading or managing a production-oriented team
- Strong collaboration skills
- Strong reporting and data analysis skills and experience
- Ability to load balance and prioritize work to meet key performance metrics around TAT and quality
- Drive and oversee productivity of staff
- Experience with new Medicaid state implementation related to provider requirements
- Leadership skills including staff development
- Critical thinking and problem-solving skills
- Familiarity with Provider Data/Enterprise systems
- Strong skills in Microsoft products
- QuickBase knowledge
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
provider operationsprovider relationsnetwork operationsMedicaid provider operationsdata analysisperformance metricsstaff performance monitoringstaff developmentprovider data accuracyproduction-oriented team management
Soft Skills
collaborationleadershipcoachingcritical thinkingproblem-solvingcommunicationmotivationload balancingprioritizationmentoring