Anticipated End Date:

2024-12-11

Position Title:

Provider Operations Manager - Provider Data

Job Description:

Provider Operations Manager - Provider Data 

Location: This position will work a hybrid model (remote and office). Ideal candidates must live within 50 miles of a PulsePoint location.

The Provider Operations Manager - Provider Data is responsible for developing, executing, and delivering operational readiness plans for provider experience strategic initiatives. Will be primarily focused on managing provider data for national providers.

How you will make an impact:

•    Leads the standardization of operational readiness plans for provider experience initiatives and mentors team members. 
•    Coordinates the development and delivery of required training to support the needs of the project team and operational/production users. 
•    Facilitates development and delivery of job aids for production operational users. 
•    Monitors overall impact to Provider Experience Key Performance Indicators to identify and facilitate changes. 
•    Manages pre and post-implementation claims audits to identify and facilitate changes to provider experience processes. 
•    Provide subject matter expertise support for projects and Small Systems Change Requests delivery. 
•    Leads and defines standards for provider experience business applications. 
•    Identifies, leads, and/or participates in targeted continuous improvement activities.

Minimum Requirements:

BA/BS degree in Business or related field and a minimum of 5 years within a healthcare organization supporting operations, provider, or claims including experience with delivery of business systems and/or process improvement; minimum of 5 years of provider experience in business disciplines within provider experience (provider call center, pricing, provider demographics); or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences:

•    Experience in credentialing, roster management, network adds, and coordinating operations between market and national business rules is strongly preferred. 
•    Project management is a plus.
•    Elevance Health experience is strongly preferred. 

Job Level:

Non-Management Exempt

Workshift:

Job Family:

PND > Provider Relationship Account Mgmt

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.