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Form of workManager, Data Integrity Requisition #: 6644 Category: Non-Bargaining # of openings: 1 Location: New York, NY Fund: 1199SEIU Benefit and Pension Funds Pay Range: $89,300.00 - $111,600 Department: Data Management Work Hours: M - F, 9:00 a.m. to 5:00 p.m. Position Status: Permanent Workplace Arrangement: Hybrid Employment Type: Full time
Description
Responsibilities:
Develop and implement data governance policies and procedures to ensure Data Integrity and accuracy related to provider demographic information and provider correspondences across all Funds provider internal systems
Implement data entry rules to identify and correct provider demographic discrepancies, including inaccuracies in provider information and communications
Establish a process to verify and update the provider directory information for all Funds' directly participating providers and facilities' demographic data for over 30,000 providers
Define and enforce data standards and data quality rules
To develop a protocol of responding and following up with requests by telephone and electronic communications in compliance with the approved criteria of the Funds, healthcare regulations, and the No Surprises Act (NSA)
Establish and maintain a process for data quality assessment and validation
Conduct audits to identify and correct errors and inaccuracies in support of maintaining provider data and data entry standards
Manage and assist the Supervisor to ensure staff is functioning in accordance with established departmental procedures, Human Resources guidelines, and provisions of the Collective bargaining
Support the Data Analyst, and Business Systems Analyst to ensure the accuracy of assigned workflows pertaining to provider demographic data complies with approved standards with Funds' contracted providers
Act as a Liaison and lead meetings with IT, Claims, Provider Relations Units, and relevant departments to ensure data accuracy and consistency of provider data to ensure standards and guidelines are being adhered
Investigate and resolve provider data-related issues promptly
Identify opportunities for process improvement and implement enhancements to ensure ongoing Data Integrity
Generate monthly executive summary reports detailing department and staff production summaries, trends, and anomalies to assist with staff training
Create monthly ad hoc reports on provider data quality metrics and communicate findings to leadership
Ensure accurate, up-to-date provider data is available to the Funds members and providers
Qualifications:
Bachelor's degree in Business Management or Healthcare Management or equivalent years of experience required
Minimum of five (5) years managerial experience in provider relations, healthcare provider data management, or a related role that included two (2) years in a leadership role
Business operations experience, including quality oversight required and provider outreach
Strong management and leadership skills required; ability to coach, mentor, and motivate staff; generate and implement improvement plans; address staff training needs
Knowledge of healthcare provider data standards, project management, and regulations
Demonstrated organizational skills with the ability to multi-task, prioritize tasks, and meet operational deadlines. Excellent critical thinking and problem-solving skills; required
Intermediate skill level with Microsoft Excel, Word, Outlook, Access, and Internet Research; required
Sound working knowledge of tables, forms, queries, statistical concepts, methods, and data collection procedures required; able to prepare comprehensive reports
Knowledge of provider systems and health claims systems (QNXT, Cactus, DMS, provider demographic form, RightFax, etc.); required
Ability to research information and analyze data to arrive at valid conclusions and recommendations
Strong decision-making skills
Effective written, verbal communication, and interpersonal skills to present clear, concise, and accurate information; facilitate meetings and manage diverse groups and build relationship with team employees and internal staff.
We offer extraordinary benefits including outstanding health, dental, pension and family benefits for most positions which are paid entirely by the Funds without co-payments, deductibles, or out-of-pocket expenses for covered services. We also offer tuition reimbursement, generous holiday, vacation, and sick leave, as well as a 401K plan.
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