Mgr Prov Network Operations
The Provider Network Operations Manager has the responsibility of the day-to-day oversight of the Provider Data Administration Business Support team. The team’s job responsibilities require testing various reimbursement methodologies, providing analysis of complex systems, resolution of business and contracting issues related to provider data set-up and quality review. In addition, the manager is also responsible for the development of processes and tools to improve operational efficiency and accuracy within the provider network area. The manager leads and empowers direct reports to identify and conceptualize from a business perspective, what the business needs and pursue innovative solutions to enhance automated processing.
Bachelor’s degree in Business or Healthcare Management. Six years of progressive experience in healthcare with prior supervisory experience required. In-depth knowledge of managed care and professional payment systems is required. Demonstrated knowledge of various operational departments including Claims, Medical Policy, Contracting, Network Data Administration, Network Services, Credentialing and Informational Services is preferred. Self-motivated, highly organized, detail oriented, as well as possesses above average problem solving, analytical and communication skills (both written and verbal). The ability to manage complex projects simultaneously and customer expectations to successful conclusion and the ability to interact with all levels of management is required. Advanced proficiency in CPR, Access, Excel, and Word.
Diversity, Equity, and Inclusion
At AmeriHealth, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
About Our Company
Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.
At AmeriHealth, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com. We’re revolutionizing health care, and our focus is on you!
Equal Employment Opportunity
AmeriHealth is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.
Agency Disclaimer
All resumes submitted directly to an AmeriHealth employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of AmeriHealth and the Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by AmeriHealth or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.