3-5 years of experience
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Employment Type:
Full time
Job Category:
Manager, Provider Data
(This job is no longer available)
Premera Blue Cross | Spokane, WA
Grad Date

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Job Description

Join Our Team: Do Meaningful Work and Improve People's Lives

Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.

To better serve our customers, we're creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!

As the Manager - Provider Data, you will provide tactical planning and oversight of the daily operations of the Provider Data team. In addition, you manage the implementation of provider information management strategy and goals.

This role will apply broad expertise in the areas of project management, business analysis, data analysis and reporting, in conjunction with strong leadership skills, to successfully implement business initiatives and focus on continuous improvement of processes and systems to meet business needs. We are seeking a talented leader that fosters strong team atmosphere, with an emphasis on excellent customer service.

What you will do:

* Develop work plans, assign work, participate in, and oversee efforts associated with business process analysis, business systems analysis, data analysis, and reporting.
* Lead work groups in the analysis of complex workflow, data and business requirements, project budgets and analysis. Consistently and effectively direct and communicate project status, schedules, budgets and risk assessments. Development an oversight of department budget and project budgets.
* Consult and work with internal partners to identify key performance and quality measures for provider data and lead multiple teams in achieving these measures. Identify key business issues and recommend and implement solutions.
* Act as an internal consultant, providing guidance on more complex projects and planning resources to meet project deadlines.
* Ensure compliance with all federal and state regulations with regards to credentialing standards and provider data accuracy. Includes both internal and external audit requirements and timely response to meet requirements.
* In conjunction with business leadership and IT, develop yearly project pipeline, including initiative business case development.
* Develop and oversee company work-intake process for systems, data, and reporting requests. Document inefficiencies or gaps in existing processes and recommend specific and innovative changes to effect improved efficiencies.
* Work with the business to analyze the cost and expected benefit of proposed initiatives, evaluate the cost/benefit against other proposals and prioritize work accordingly.
* Lead business process improvement efforts. Analyze and measure the effectiveness of existing processes and develop sustainable, repeatable and quantifiable process improvements that focus on increased productivity, reduced cost and improved experience. Help develop standards and practices for effective oversight.
* Act as the liaison to third party organizations support Premera's credentialing and provider information management activities.
* Partner with Account Management and Service to implement external vendor solutions and partnerships.
* Define test strategies; lead the development of test plans and test scripts. Lead the integrated quality assurance testing to validate modifications and enhancements in accordance with specifications.

What you will bring:

* Bachelor's degree in Computer Science, Business Administration, Healthcare Administration or a related field or four (4) years of work experience.
* Five (5) years of health plan industry experience or business/operational experience.
* Five (5) years of progressive management experience.
* Experience leading multiple/complex teams
* Lean or Six Sigma certification and project management experience is preferred



What we offer

* Medical, vision and dental coverage
* Life and disability insurance
* Retirement programs (401K employer match and pension plan)
* Wellness incentives, onsite services, a discount program and more
* Tuition assistance for undergraduate and graduate degrees
* Generous Paid Time Off to reenergize
* Free parking

Equal employment opportunity/affirmative action:

Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.

If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.

About Premera Blue Cross

Premera Blue Cross is a non-profit health services corporation and an independent licensee of the Blue Cross Blue Shield Association. Premera Blue Cross has been providing coverage to groups and individuals of Washington state since 1945 and Alaska since 1957. Headquarters are located in Mountlake Terrace, Washington, with district offices in Spokane, Wenatchee and Tri-Cities Washington, and Anchorage, Alaska. The Premera Blue Cross HMO plan, HealthPlus, is one of only two health plans in Washington to be awarded Excellent Accreditation from the National Committee for Quality Assurance (NCQA), as of March 2000.