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

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

Manager – Medicaid Provider Data Services

Key skills