Position Overview This position directly interfaces with the Claims, Provider Network Operations, UM, IT, Credentialing, and ProviderContracting Departments as well as internal/external customers. The incumbent will provide day-to-day supervision of staff and must be able to perform all Provider Maintenance Representative functions as needed. Scope of Role & Responsibilities • Document departmental policies and procedures. • Create/modify departmental user manuals. • Monitor staff performance including performance reviews. • Assist in resolving escalated provider participation issues from the Manager of Provider Maintenance and senior management. • Working closely with the Core Systems and Claims teams as well as SS&C. The incumbent will modify existing data to reflect updated provider information as needed. • Determine the impact of requested changes to the providers and claims • Assist requestor in determining the specifics of a given provider change request and assist and update to fulfill request. • Plan and implement procedures and systems to maximize operating efficiency • Address escalated inquiries from the Claims, Provider Network Operations, UM, IT, Credentialing, and Provider Contracting Departments as well as internal/external customers. • Address daily emails received from internal and external customers. • Assist in the 1099 reporting process • Assist in MedHome/Uploads/Communication Grid updates, when needed • Monitor and track activities related to the contract load process • Perform system testing as it relates to claims processing and provider setup • Develop processes as needed. Required Education, Training & Professional Experience • Bachelor’s Degree; and • Minimum 2 years’ relevant supervisory experience required; or • A satisfactory equivalent combination of education, training, and experience Docusign Envelope ID: D4377095-C3F7-84DF-802F-C2C26D6249CE • Knowledge of Health Rules Payor (HRP), Word, Excel, and Access preferred Professional Competencies • Integrity and Trust • Customer Focus • Functional/Technical skills • Excellent oral and written communication skills. • Analytical and problem-solving abilities. #MPH50 #LI-Hybrid