Director, Provider Data Management

Altais

Base: $141,900 - $170,280pyr; bonus/equity: eligib...
Fully remote
End-to-end provider data management
Ncqa, caqh, cms compliance
Delegated credentialing oversight
The Director, Provider Data Management is responsible for the end to end process driving accurate, compliant and timely provider data management, ensuring compliance with National Committee for Quality Assurance (NCQA), CAQH standards, CMS, state and federal regulations and individual health plan requirements

Job Summary

  • The Director, Provider Data Management is responsible for the end to end process driving accurate, compliant and timely provider data management, ensuring compliance with National Committee for Quality Assurance (NCQA), CAQH standards, CMS, state and federal regulations and individual health plan requirements.
  • This role leads and mentors a team responsible for services throughout affiliated entities and will champion increased provider satisfaction by working with Network Operations, Contracting and Network Development to expedite the contracting process.
  • The Base Salary for this position is $ 141,900 - $170,280/yr In addition, we provide a competitive compensation package that recognizes your experience, credentials, and education alongside a robust benefits program to meet your needs.

Matching Summary

The Director, Provider Data Management is responsible for the end to end process driving accurate, compliant and timely provider data management, ensuring compliance with National Committee for Quality Assurance (NCQA), CAQH standards, CMS, state and federal regulations and individual health plan requirements.

Salary

Base: $141,900 - $170,280/yr; Bonus/Equity: Eligible to participate in annual bonus program; Benefits: Excellent medical, vision, and dental coverage, 401k savings plan with company match, Flexible time off and 9 Paid Holidays

Skills & Requirements

Must-have

  • End-to-end provider data management
  • NCQA, CAQH, CMS compliance
  • Delegated credentialing oversight
  • Provider directory management
  • Credentialing software and automation
  • Leadership and team mentoring
  • Policy and procedure development

Nice-to-have

  • Collaborative team environment
  • Purpose-driven healthcare transformation
  • Agile and adaptable work style
  • Integrity in operations
  • Continuous improvement focus
  • Championing provider satisfaction

Key Requirements

  • Bachelor’s degree or equivalent
  • 10+ years credentialing/regulatory affairs experience
  • 6+ years leadership experience
  • Experience with MSO, Health Plan, or large provider practice
  • Credentialing software experience
  • Experience leading Health Plan audit activities
  • Experience presenting to leadership
  • Ability to develop management reports
  • Knowledge of CAQH and credentialing processes
  • Knowledge of delegated credentialing and verification
  • Knowledge of accreditation and certification requirements
  • Knowledge of medical credentialing procedures
  • Ability to create, implement, document and audit policies
  • Ability to lead and manage remote teams
  • Eligible for NAMSS Certified Provider Credentialing Specialist exam

Work Rights

Not specified

Tailored Resume

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