Manager of Member and Provider Data (Health Plans)

Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

• Oversees the Enrollment and Provider Data management departments. Coordinates and monitors all aspects of Enrollment, inclusive of but not limited to overseeing key enrollment processes; ensuring adherence to turnaround times, accuracy requirements, other regulatory requirements; and recommending modifications to policies and procedures based on regulatory changes and industry standards. Coordinates and monitors all aspects of provider data management, inclusive of but not limited to overseeing key provider data management processes such as inputting provider data and updating provider data, ensuring the ongoing quality of provider data, and recommending modifications to policies and procedures based on regulatory changes and industry standards.

• Bachelor's Degree required.
• Two (2) years progressive leadership experience required.
• Three (3) years experience in health plan data handling and/or oversight required.
• Experience in Enrollment and Provider data required.
• Experience and understanding of Facets system required.
• Significant site management experience including leading large teams and managing cross functional teams preferred.

• Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
• Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
• Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
• Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
• Knowledge of the health insurance and managed care industry.
• Member and provider data knowledge – In-depth understanding of member and provider data. Understands key member and provider data systems and relevant capabilities. Understands enrollment and provider data staff level resource needs and constraints.

• Rarely (1 - 10% of the time)	Occasionally (11 - 33% of the time)	Frequently (34 - 66% of the time)	Continually (67 – 100% of the time)
  LIFT (Floor to Waist: 0"-36") 0-20 Lbs LIFT (Knee to chest: 24"-54") 0 - 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds CARRY 2-handed, 0 - 20 pounds KNEEL (on knees) BEND FORWARD at waist CLIMB - STAIRS	STAND WALK - LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0-20 pounds force) PULL (0-20 pounds force)	SIT ROTATE TRUNK Sitting REACH - Forward MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist	None specified