Manager, Provider Data Management (7991)
Evolent Health
Pune, Maharashtra, India
5d ago

Information Technology Manager, Provider Data Management Pune, Maharashtra, India

Manager, Provider Data Management

It’s Time For A Change

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day.

We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins.

We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

  • Are we growing? Absolutely 56.7% in year-over-year revenue growth in 2016. Are we recognized? Definitely. We have been named one of Becker’s 150 Great Places to Work in Healthcare in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts : Evolent achieved a 95% score on its first-ever submission to the Human Rights Campaign’s Corporate Equality Index;
  • was named one of the Best Companies for Women to Advance List 2020 by; and we publish a Diversity and Inclusion Annual Report to share our progress on how we’re building an equitable workplace.

    We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day.

    If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission.

    Join a mission with a company behind it.

    What You’ll Be Doing :

  • Assumes lead role for Provider Data Management / Provider Enrollment with implementation support of health plan initiatives, goals, and related projects including, but not limited to, Pay for Performance physician programs and implementation of behavioral health services
  • Determines project requirements and deliverables to establish a work plan appropriate to identified project
  • Leads project implementation through personal involvement in issue resolution as well as delegating task completion to appropriate departmental and company staff resources
  • Collaborates with key management and staff to assist in the design and implementation of processes and procedures to improve performance
  • Ensures successful completion and implementation of projects within established time frames
  • Evaluates project outcome and develops tracking and reporting mechanisms to monitor activities, identifies opportunities for improvement and implements interventions and measure their effectiveness
  • Functions as Provider Data Management representative on internal cross functional meetings, committees and workgroups
  • Displays effective human and interpersonal relations skills with staff and the delegations of work assignments
  • Works in a collaborative manner with key staff to assist in the timely, accurate and effective management of department and company initiatives
  • Analyzes departmental processes, procedures and practices to proactively identify and implement measures that increase performance and achieve departmental goals
  • Regularly suggests innovative means of structuring project workflow in a fashion that helps alleviate backlogs and ensures the maximum utilization of resources
  • Responsible for having in depth working knowledge of all managed care activities : Member Services, Credentialing, Operations, Claims and Funding and Recovery, Member Enrollment, Provider Services, etc.
  • in order to provide solutions and options for service and problem solving

  • Assures root cause analyses of issues are identify possible break fixes
  • Manages resolution of escalations in a timely manner, including through documentation of process improvement activities
  • Works collaboratively with health plan team members to identify policies / procedures that may precipitate issues and offers alternatives
  • Assures communication and / or implementation of best practices regarding provider initiatives.
  • Utilizes quality improvement tools to streamline and optimize processes to assure administrative efficiency
  • Demonstrates knowledge of management practices, protocols and managerial principles in decision-making
  • Displays ability to anticipate and be responsive to management needs and exercise proper judgment in performance
  • Displays a high degree of cooperation in accepting and completing multiple special assignments simultaneously within prescribed timeframes
  • Performs other duties and projects, as assigned
  • Key Competencies / Success Factors :

  • Lives the values : Integrity, Community, Collaboration and Stewardship, as defined in the performance appraisal
  • Proficient PC skills with success in managing provider data in a claim, credentialing or provider platform and in a Microsoft Office based environment
  • Excellent verbal and written communication skills, with the ability to productively interface with and support clients
  • Detail oriented with good organizational skills and ability to review and evaluate data with accuracy in a timely manner
  • Adept at working through complex issues and presenting appropriate solutions for review and decisions in a cross functional environment
  • Aptitude to work collaboratively with managers, colleagues and team members across departments and clients
  • Ability to successfully handle multiple high priority projects, with critical leadership and client visibility,
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