Manager-Member and Provider Data (Remote) Job at Samaritan Health Services
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- Bonus available to new employees and may require previous work experience. Employment commitment to Samaritan is required.
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Bachelor's Degree required.
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Two (2) years progressive leadership experience required.
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Three (3) years experience in health plan data handling and/or oversight required.
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Experience in Enrollment and Provider data required.
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Experience and understanding of Facets system required.
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Significant site management experience including leading large teams and managing cross functional teams preferred.
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Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
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Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
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Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
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Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
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Knowledge of the health insurance and managed care industry.
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Member and provider data knowledge – In-depth understanding of member and provider data. Understands key member and provider data systems and relevant capabilities. Understands enrollment and provider data staff level resource needs and constraints.
Oversees the Enrollment and Provider Data management departments. Coordinates and monitors all aspects of Enrollment, inclusive of but not limited to overseeing key enrollment processes; ensuring adherence to turnaround times, accuracy requirements, other regulatory requirements; and recommending modifications to policies and procedures based on regulatory changes and industry standards. Coordinates and monitors all aspects of provider data management, inclusive of but not limited to overseeing key provider data management processes such as inputting provider data and updating provider data, ensuring the ongoing quality of provider data, and recommending modifications to policies and procedures based on regulatory changes and industry standards.
Rarely
(1 - 10% of the time)
Occasionally
(11 - 33% of the time)
Frequently
(34 - 66% of the time)
Continually
(67 – 100% of the time)
LIFT (Floor to Waist: 0"-36") 0-20 Lbs
LIFT (Knee to chest: 24"-54") 0 - 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
CARRY 2-handed, 0 - 20 pounds
KNEEL (on knees)
BEND FORWARD at waist
CLIMB - STAIRS
STAND
WALK - LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0-20 pounds force)
PULL (0-20 pounds force)
SIT
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
None specified
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