The Supervisor of Provider Systems will supervise the day-to-day operations of the Provider Relations (PR) Department functions involving provider data used for operations, reporting and claims processing. Provides supervision, support and guidance to the PR Systems staff. Monitors inventory and disseminates work based on timeliness standards and competing priorities.

• Supervises the daily functions of PR department Systems staff.
• Monitors staff productivity, quality, accuracy and service delivery based on performance
  standards. Ensures regulatory timeliness standards are met consistently.
• Monitors inventory control reports to ensure timeliness standards are being met. Assigns
  or reassigns work required to maintain service levels.
• Provides management with weekly updates on the inventory status and recommended
  actions required to ensure daily functions are adequately addressed.
• Coaches staff to work with providers and internal departments to ensure providers are
  set-up accurately and resolve data discrepancies affecting claims payments and reporting.
• Meets monthly with direct report staff to provide performance feedback
• Ensures regulatory reports and provider directories meet compliance standards
• Oversees provider network reporting, responding to internal inquires for ad hoc reports.
• Develops, implements and oversees training plans for new hires and ensure training
  progresses according to schedule. Ensure training guides and tools are developed and upto-date.
• Oversees the successful completion of ongoing training plans to ensure adequate
  redundancy for all functions.
• Supports staff development by identifying new training opportunities and shadowing at
  interdepartmental meetings.
• Maintains updated desk procedures and other resource materials and oversee the timely
  completion of written procedures by staff as assigned.
• Interviews and participates in selection of PR staff that will directly report to supervisor.
• Writes and conducts staff performance evaluations.
• Acts as a liaison with internal PHC Departments to assist with resolving questions
  relating to provider data and system set-ups.
• Ensures the team conducts timely outreach to resolve data discrepancies and obtain
  information required to ensure reporting and claims are accurate.
• Supports PR with provider network reports and regulatory deliverables involving
  provider data.
• Participates in workgroups designed to improve accuracy or support regulatory
  directives.
• Attends internal and external meetings and participate in or recommends solutions to
  issues.
• Recommends process improvements designed to improve efficiency.
• Promotes a positive attitude, teamwork and fun in the workplace.
• Other duties as assigned.

All HealthPlan employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the HealthPlan’s policies and procedures as they may from time to time be updated.

HIRING RANGE:

 $93,690.86 - $117,113.58

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform.  The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.