This position supervises the provider data quality, electronic/systems interfaces, and provider data entry and management functions for all employed and Health Network related activity. Through effective staffing and management of work functions, assures the accurate, timely and cost-effective completion of provider data electronic and manual processes including data entry into the claims system, provider data administrative tool, and data imported through the electronic interfaces, auditing, evaluation, , and reporting.
Supervises the operations of all provider data management for employed providers and Health Network providers. Develops, manages and maintains work processes and procedures for provider data entry into the claims system, management of electronically imported provider data, development and management of a provider data quality program and reporting.
Selects, trains, coaches, motivates, conducts performance evaluations, and directs the workflow for the assigned Provider Data Management staff. Develops goals and performance expectations for staff and manages staff performance.
Maintains all required records. Supervises and coordinates the maintenance of all aspects of internal records associated with the departments management information and provider data management system(s). Responsible for maintaining department reporting obligations to internal and external constituents.
Collaborates with internal and external customers; including Banner IT, contracted provider network(s), contracted health plans, Banner Medical Group, and other customers to develop and maintain business rules and relationships.
Develops and meets organization criterion related to provider data turn-around, quality, and accuracy requirements. Accountable for ensuring high performance outcomes through an integrated process of operational, quality, and resource management.
Supervises human and material resources needed to maintain or exceed department standards. Participates in the development of the department budget in conjunction with established goals and objectives. Plays a key role in ensuring budgetary goals are met on an annual basis.
Must possess the knowledge typically gained from the completion of a Bachelor's degree in business or a related field or the equivalent training and experience.
Requires the knowledge normally acquired over five or more years of experience in health plan and provider data services. Must possess extensive knowledge of managed care operations, commercial insurance contracts, and governmental reimbursement methodologies. Must have demonstrated success in effective decision making in managing a diverse staff.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.