Point32Health

Manager, Provider Directory Audit

Canton, MA

Sponsorship not specified$105k-$157kDetected 5 days ago

ExcelCommunication

About the role

The Manager, Provider Data Quality, is responsible for the development and successful oversight of the Point32Health provider directory quality audit program, including the oversight of the AI Agent for Directory Audit.
This role will be crucial in maintaining the quality and reliability of our provider data, which is essential for our operations and service delivery including the accuracy of the health plan provider directory.
This role will require subject matter expertise in providing directory regulations for Medicaid, Medicare, and Commercial products.

Design and implement a comprehensive provider directory and data audit program for continuous improvement of provider directory quality.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

Facilitate the development, implementation, of an end-to-end process supporting provider data audits to increase the accuracy of the Point32Health provider directories.
Establish policies, procedures, and standards for provider data management and audits, and roster reconciliation t.
Ensure compliance and stay informed about all relevant regulations and standards related to provider directories.
Responsible for the enterprise provider directory & attestation platform vendor oversight and performance
Establish key performance indicators (KPIs) and metrics to measure the effectiveness of the provider directory and data audit program.
Associates, bachelor's, or other advanced degree preferred.
Equivalent work experience required.
Master's degree preferred.

$104,612.00 -$156,918.00
Compensation & Total Rewards Overview
The annual base salary range provided for this position represents a range of salaries for this role and similar roles across the organization.
The actual salary for this position will be determined by several factors, including the scope and complexity of the role; the skills, education, training, credentials, and experience of the candidate; as well as internal equity.
As part of our comprehensive total rewards program, colleagues are also eligible for variable pay.
Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare.
Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone.
We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background; it's at the core of who we are.
Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

Point32Health is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable healthcare. Serving nearly 2 million members, Point32Health builds on the legacy of Harvard Pilgrim Health Care and Tufts Health Plan to provide access to care and empower healthier lives for everyone. Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions. We've had a long-standing commitment to inclusion and equal healthcare access and outcomes, regardless of background
it's at the core of who we are. We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.
We enjoy the important work we do every day in service to our members, partners, colleagues and communities. Learn more about who we are at Point32Health.
Our culture revolves around being a community of care and having shared values that guide our behaviors and decisions.
We value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work.
Learn more about who we are at Point32Health.

This listing is sourced directly from Point32Health's careers page and normalized into a canonical job model.