Manager, HP Data Reconciliation

Job Summary:

The Manager, HP Data Reconciliation develops and manages all processes related to inbound and outbound provider data files

Essential Functions:

• Perform supervision and support of the Health Partner Lifecycle (HPLC) Data Reconciliation team members
• Develop and manage all processes related to inbound and outbound provider data files
• Responsible for accurate and timely updates to data exceptions
• Provide direction and oversight of business processes to ensure accurate setup and maintenance of defined provider information in applicable systems, and ensure compliance with provider contract documents
• Maintain subject matter expertise of all supported provider data files
• Assure that data entry activities are accurate, timely, and compliant with state and regulatory standards
• Develop, document and perform testing and validation as needed for process and system changes
• Serve as primary point of contact for vendors and business partners that are sending and receiving CareSource provider data
• Coordinate efforts with markets and other CareSource departments to ensure all data needs are met
• Actively participate in the Operations Management Team and meetings
• Conduct performance evaluations, hiring, and disciplinary action decisions
• Conduct root cause analysis on escalated issues
• Coordinate data entry activities related to assignments, problem solving, and project management
• Supervise staff for quality review, performance feedback, disciplinary issues, and merit/bonus appraisal review
• Create, review, revise, and enforce company and departmental policies and procedures
• Provide mentoring, training, and ongoing education in regards to optimal performance and Standards of Excellence
• Perform any other job duties as requested

Education and Experience:

• Bachelor’s Degree in business, healthcare or related field or equivalent years of relevant work experience is required
• A minimum of three (3) years of experience in data analysis and/or root cause analysis required
• A minimum of three (3) years of experience working with operations or IT is required
• A minimum of three (3) years of experience in a leadership role is required
• Experience working with provider data preferred
• Experience working with Excel, SQL, and Microsoft Access preferred

Competencies, Knowledge and Skills:

• Advanced computer skills, specifically working with data
• Proven understanding of business process
• Proven critical thinking and analysis skills
• Experience writing and/or interpreting system requirements preferred
• Communication skills
• Ability to work independently and within a team environment
• Training/teaching skills
• Attention to detail
• Ability to effectively support diverse personalities and work styles
• Familiarity of the healthcare field
• Knowledge of Medicaid
• Critical listening and thinking skills
• Strategic management skills
• Use of proper grammar
• Technical writing skills
• Time management skills
• Proper phone etiquette
• Customer service oriented
• Decision making/problem solving skills
• Knowledge of medical terminology
• Ability to identify and recommend process improvements

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business