Provider Operations Director

Elevance Health - New York, NY

Full-time - Mid Level

Hybrid - New York, NY

11-50 employees

Insurance Carriers and Related Activities

About the position

The Provider Operations Director at Elevance Health is responsible for overseeing data file integrations, conducting data analysis, and managing relationships with health plans and state or vendor leads. This role involves strategic oversight of data processes, supporting new implementations, and enhancing data quality initiatives within the healthcare operations sector.

Responsibilities

• Coordinate data file integrations and fallout data analysis.
• Conduct data clean-up and remediation efforts.
• Support relationships with Health Plans and state or municipal leaders.
• Participate in and influence success in new data file implementations.
• Support initiatives that address provider data quality and automation opportunities.
• Provide subject matter expertise on strategic initiatives and act as a liaison to IT and other business partners.
• Identify high-value initiatives in partnership with management.
• Facilitate changes to provider experience processes based on audit lessons learned.
• Lead standardization of operational readiness plans for provider experience initiatives.
• Mentor team members on best practices and execute strategic initiatives effectively.

Requirements

• BA/BS degree in business or a related field.
• Minimum of 7 years of management experience in healthcare operations or network management.
• Enterprise-level project management experience or equivalent education and experience.

Nice-to-haves

• Master's degree preferred.
• PMP certification preferred.
• 5-7 years of experience in process improvement, data analytics, and relationship management within a healthcare environment.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs
• Medical, dental, and vision benefits
• Short and long-term disability benefits
• 401(k) with matching
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources