Provider Operations Manager - Contracting & Operations Support

Elevance Health-posted about 1 year ago
Full-time • Mid Level
Atlanta, GA
11-50 employees
Insurance Carriers and Related Activities
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The Provider Operations Manager - Contracting & Operations Support is responsible for developing and executing operational readiness plans for provider experience strategic initiatives. This role involves leading standardization efforts, coordinating training, monitoring key performance indicators, and managing claims audits to enhance provider experience processes.

  • Leads the standardization of operational readiness plans for provider experience initiatives and mentors team members.
  • Coordinates the development and delivery of required training to support the needs of the project team and operational/production users.
  • Facilitates development and delivery of job aids for production operational users.
  • Monitors overall impact to Provider Experience Key Performance Indicators to identify and facilitate changes.
  • Manages pre and post-implementation claims audits to identify and facilitate changes to provider experience processes.
  • Provides subject matter expertise support for projects and Small Systems Change Requests delivery.
  • Leads and defines standards for provider experience business applications.
  • Identifies, leads, and/or participates in targeted continuous improvement activities.
  • BA/BS degree in Business or related field.
  • Minimum of 5 years within a healthcare organization supporting operations, provider, or claims.
  • Experience with delivery of business systems and/or process improvement.
  • Minimum of 5 years of provider experience in business disciplines within provider experience (provider call center, pricing, provider demographics).
  • Experience with provider contracting, account management, meeting facilitation/calendar management.
  • Experience with Contraxx, PIMS, Availity, SPS is strongly preferred.
  • Minimum of five years of experience in primary care quality performance evaluation or management preferred.
  • Analytics experience with value-based data.
  • Ability to interpret performance data and report findings to providers and senior leadership strongly preferred.
  • Merit increases
  • Paid holidays
  • Paid Time Off
  • Incentive bonus programs
  • Medical benefits
  • Dental benefits
  • Vision benefits
  • Short and long term disability benefits
  • 401(k) with matching
  • Stock purchase plan
  • Life insurance
  • Wellness programs
  • Financial education resources
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