What are the responsibilities and job description for the Provider Data Supervisor position at CareOregon?

Career Opportunities : Provider Data Supervisor (24830)

verp-client : SMRF Globals
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Enter a list of words, and we\u2019ll search for them in the job title, or you can choose to search for them also within the job description.

Tips : \n \n

We will find results for any words listed

in the search

Results beginning with words searched will also be returned. Ex : A search for \u201cManage\u201d will return \u201cmanage, manager, management\u201d etc.

To find an exact phrase, surround your search phrase with double quotes (\u201d \u201c). Ex : \u201csenior manager\u201d, or check \u2018Exact match\u2019.

Advanced search : \n \n

Use AND, OR, NOT, and () to combine search terms. Ex : Sales AND engineer

finds only jobs that have both terms. \n

Sales OR engineer

finds all jobs that have either.

n (Sales AND Engineer) NOT Manager

finds jobs that contain both \u201cSales\u201d and \u201cEngineer\u201d but not \u201cManager\u201d.

Use question mark (?) for an unknown letter. Ex : Thomps?n finds Thompson, Thompsen, Thompsan, etc.

Use tilde (~) to find similar spellings. Ex : roam~ finds roam, roams, room, road, roads, etc.

Do not use advanced search options if you have checked \u2018Exact match\u2019.

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verp-client : SMRF Globals

function(w){function set(k,v){Object.assign(k==='window'?w : (w[k]=w[k]||{}),v)}set("MSGS",{RECRUITING_CAREERS_SAVED_APPLICATIONS : "Saved Applications",RECRUITING_CONTINUE_WITH_DRAFT_APPLICATION : "Continue",RECRUITING_DRAFT_DELETE : "Delete Application",RECRUITING_DRAFT_OPEN_APPLICATION : "Apply",RECRUITING_DRAFT_SELECT : "Select",RECRUITING_OPEN_NEW_APPLICATION : "Start Over",RECRUITING_OPEN_NEW_APPLICATION_USING_LINKEDIN : "Use LinkedIn\u2122 Profile Data",RECRUITING_PLEASE_SELECT_YOUR_OPTION : " You have an existing job application for this requisition

click \u201cContinue\u201d to use user saved application.

click \u201cStart Over\u201d for a new application (this will delete your saved application).

RECRUITING_SAVED_APP_VS_LINKEDIN_DATA : " You have an existing job application for this requisition

click \u201cContinue\u201d to use user saved application.

click \u201cUseLinkedIn\u2122 Profile Data\u201d for a new application (this will delete your saved application).

window)

verp-client : SMRF Globals

function(w){function set(k,v){Object.assign(k==='window'?w : (w[k]=w[k]||{}),v)}set("MSGS",{COMMON_All : "All",COMMON_Clear : "Clear",COMMON_Country : "Country / Region",COMMON_Description : "Description",COMMON_Email : "Email",COMMON_More : "More",COMMON_MultiSelect_Hierarchical_Available_Label : "Available ({0})",COMMON_MultiSelect_Hierarchical_Primary_Label : "Primary",COMMON_MultiSelect_Hierarchical_Selected_Label : "Selected ({0})",COMMON_Required_Field_Err : "{0} is a required field.",COMMON_Required_Fields_Err : "{0} are required fields.",COMMON_Search : "Search",COMMON_Send : "Send",COMMON_no_items : "No items to display",RCM_FILE_UPLOAD_INSTRUCTION_NO_HTML : "Accepted File types : DOCX, PDF, Image and Text",RCM_INVALID_FIRST_NAME : "Invalid first name.",RCM_INVALID_LAST_NAME : "Invalid last name.",RCM_JRS_JOB_POSTED_ON : "Posted on {0}",RCM_MULTISELECT_MAKE_PRIMARY_VALUE : "Make Primary",RCM_MULTISELECT_PRIMARY_VALUE : "Primary",RCM_SELECT_USER_AUTOCOMPLIST_EXPANDED : "One or more results are available, use up and down arrow keys to navigate.",RECRUITING_ACCESSIBLE_MFIELD_ALL_SELECTED : "All values selected",RECRUITING_ACCESSIBLE_MFIELD_NO_SELECTION : "No value selected",RECRUITING_ACCESSIBLE_MFIELD_SELECTED_VALUE : "Selected value",RECRUITING_ACCESSIBLE_MFIELD_SELECTED_VALUES : "Selected values",RECRUITING_ACCESSIBLE_MULTISELECT_TITLE_FOR_TEXT : "Select one or more options for {0} multiselect combobox with checkbox options.",RECRUITING_ACCESSIBLE_MULTISELECT_TITLE_TEXT : "Select one or more options for multiselect combobox with checkbox options.",RECRUITING_ADDING_REFERRAL : "Adding Referral...",RECRUITING_ADD_REFERRAL : "Add Referral",RECRUITING_ADD_REFERRAL_FAILED : "Failed to Add Referral due to internal processing error.",RECRUITING_ADD_RESUME : "Add resume",RECRUITING_COMMON_ANY : "Any",RECRUITING_CSW_SELECTED : "selected",RECRUITING_Clear_all : "Clear all",RECRUITING_EMAIL_JOB_BUTTON : "Email Job to Friend",RECRUITING_ERP_MISSING_COUNTRY_PICKLIST : "Configuration Error : country / region picklist is undefined. Please contact your System Administrator.",RECRUITING_ERP_REQUIRE_RESUME_CONFIG_ERR : "Configuration Error : Attachment feature is disabled but Resume is a required field in Employee Referral Admin Setup page. Please contact your System Administrator.",RECRUITING_Edit_View_options : "Edit or view selected options",RECRUITING_FIELD_REQUIRED : "Required",RECRUITING_FIRST_NAME : "First Name",RECRUITING_GET_ADD_REFERRAL_INFO_ERROR : "Internal get add referral information processing error.",RECRUITING_HelpInfo : "Select or search for items from this list. Review your selection in the selected bucket. Click Done to add.",RECRUITING_INVALID_EMAIL : "Invalid email.",RECRUITING_JOB_LANG_POSTED_AS : "Posted as",RECRUITING_JOB_LISTING_APPLY : "Apply",RECRUITING_JOB_LISTING_APPLY_USING_LINKIN : "Apply Using LinkedIn\u2122",RECRUITING_JOB_LISTING_SAVE_JOB : "Save Job",RECRUITING_JOB_REQUISITION_INVALID_ENTRY : "Invalid entry",RECRUITING_JOB_REQ_ERR_MSG : "No picklist associated for field \u201c{0}\u201d. Please contact your administrator to have the correct picklist associated in configuration.",RECRUITING_JOB_SEARCH_JOB_DATE_POSTED : "Date Posted",RECRUITING_JOB_SEARCH_JOB_RELEVANCE : "Relevance",RECRUITING_JOB_SEARCH_JOB_REQ_TITLE_SORT_COL : "Job Title",RECRUITING_JOB_SEARCH_REQUISITION_ID : "Requisition ID : ",RECRUITING_JOB_SEARCH_SELECT_ACTION : "Select Action",RECRUITING_LAST_NAME : "Last Name",RECRUITING_LEFT_COLUMN : "Left Column",RECRUITING_MULTI_LANG_JOB_POSTING_LINK_TITLE : "Press enter to view job posting in different languages",RECRUITING_Multiple_selections : "Multiple",RECRUITING_PHONE : "Phone",RECRUITING_PROVIDE_INFO_BELOW : "Please provide the information below",RECRUITING_Press_Enter_Select_options : "Press ENTER to select one or more options",RECRUITING_RADIAL_SEARCH_DISTANCE_COLUMN : "Distance",RECRUITING_RADIAL_SEARCH_RESULT_UNIT_KMS : "km",RECRUITING_RADIAL_SEARCH_RESULT_UNIT_MILES : "mi",RECRUITING_REFER_FRIEND_TO_JOB : "Refer Friend to Job",RECRUITING_RIGHT_COLUMN : "Right Column",RECRUITING_Resume : "Resume",RECRUITING_Select_all : "Select all",RECRUITING_Select_none : "Select None",RECRUITING_Select_options : "Select one or more options",RECRUITING_Select_options_for : "Select one or more options for {0}",RECRUITING_Selected_Item_Count : "({0}) Selected"})}(window)

verp-client : SMRF Globals

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Are you sure you want to continue?",COMMON_DPCS2_Countries : "Countries / Regions",COMMON_DPCS2_DEL_Confirm : "You are about to delete the {0} translation for this statement. All {1} translation data will be lost.

Are you sure you want to continue?",COMMON_DPCS2_Decline : "Decline",COMMON_DPCS2_Decline_STMT : "Decline Statement",COMMON_DPCS2_Declined : "Declined",COMMON_DPCS2_Default_STMT : "Default Statement",COMMON_DPCS2_Delete_STMT : "Delete Statement",COMMON_DPCS2_Draft : "Draft",COMMON_DPCS2_Find_employee : "Find a user",COMMON_DPCS2_General_setting : "General Settings",COMMON_DPCS2_INVALID_Redirect_URL : "Invalid URL.",COMMON_DPCS2_INVALID_Redirect_URL_STMT : "Invalid redirect URL in the General Settings section.",COMMON_DPCS2_LBL_STMT : "Statement",COMMON_DPCS2_LBL_View_Stmt : "View Statement",COMMON_DPCS2_MSG_NOTE_Default_STMT : "Note that employees will see the default statement if the version of their default language is not created yet. You can create default statement message in any supported language. 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set the current state so when the form is submit for lang changed, it keep the same state. setField('career_ns', 'job_listing'); chain(window, "onload", function() { var saveRedirected = document.getElementById('joblist_jobSaveRedirect').value;var applyRedirected = document.getElementById('joblist_jobApplyRedirect').value; var isApplyViaLinkedIn = false; isApplyViaLinkedIn = document.getElementById('isApplyWithLinkedIn').value; if (saveRedirected == 'saveRedirected') { var url = " / rcmcjsup?m=saveJobReq&company=C0007187026P&sr=true&"; url = "career_job_req_id=" 24830; url = "&career_job_req_sec_key=" document.getElementById('career_job_req_sec_key').value; if (submitExternalAjaxQuery(url, ' / career?company=C0007187026P&loginFlowRequired=true&lang=en_US')) { alert(items.update_msg); return true; } setField('joblist_jobSaveRedirect', 'joblist_' 'jobSaveRedirect'); } if (applyRedirected =='applyRedirected') { var popup = new RCMExtDraftAppDialog('24830', '', isApplyViaLinkedIn); } }) function applyJobReq(isUserLoggedIn, jobReqId, jobReqSecKey, isApplyWithLinkedIn, elementId){ if (isUserLoggedIn == true || isUserLoggedIn == 'true') { var popup = new RCMExtDraftAppDialog(jobReqId, jobReqSecKey, isApplyWithLinkedIn, elementId); } else { setField('joblist_jobApplyRedirect', 'applyRedirected'); setField('career_job_req_sec_key', jobReqSecKey); setField('career_job_req_id', '24830'); setField('navBarLevel', 'JOB_SEARCH'); setField('career_os', 'job_listing'); setField('isApplyWithLinkedIn', isApplyWithLinkedIn); setFieldAndSubmit('career_ns','job_save'); } } function saveJobReq(isUserLoggedIn, jobReqId, jobReqSecKey) { var form = document.forms[0]; if (isUserLoggedIn == 'true') { var url = " / rcmcjsup?m=saveJobReq&company=C0007187026P&sr=true&"; url = "career_job_req_id=" jobReqId; url = url "&rcm_site_locale=" "en_US"; url = "&career_job_req_sec_key=" jobReqSecKey; if (submitExternalAjaxQuery(url)) { alert(items.update_msg); return true; } } else { setField('joblist_jobSaveRedirect', 'saveRedirected'); setField('career_job_req_id', '24830'); setField('navBarLevel', 'JOB_SEARCH'); setField('career_os', 'job_listing'); setField('career_ns', 'job_save'); setField('pvt_hash_key', ''); setField('pvt_hash_value', ''); form.submit(); } } function JobListingDpcs2Handler(config) { RCMDpcs2Handler.call(this, config); } extend(JobListingDpcs2Handler, RCMDpcs2Handler, { accept : function(acceptJson) { var params = this.getConfig().params; proceedWithSaveApply(params); } }); function checkDpcs2AndProceed(params) { var isPublicIntranet = false; if(params.isUserLoggedIn){ checkDpcs2AcceptanceBeforeProceeding({ createDpcs2Handler : function(dpcs2AcceptedOrDeclinedStatusFromServer) { return new JobListingDpcs2Handler( {dpcs2AcceptedOrDeclinedStatusFromServer : dpcs2AcceptedOrDeclinedStatusFromServer, params : params}); } }, isPublicIntranet); } else { proceedWithSaveApply(params); } } function proceedWithSaveApply(params){ if(params.evtSrc == 'Apply') { applyJobReq(params.isUserLoggedIn,params.jobReqId, params.jobSecKey, params.isApplyWithLinkedIn, params.elementId); } else if(params.evtSrc == 'SaveJob') { saveJobReq(params.isUserLoggedIn,params.jobReqId, params.jobSecKey, params.saveRedirect); } } function showMFieldDialog(contextId,values, config){ if(!this._valueBubble){ this._valueBubble = new MultipleValueBubble(values); }else{ this._valueBubble.setValues(values); } if(!config) { / / default values config = { refocusId : contextId, closeOnEsc : true }; } SFInfoInContext.show(this._valueBubble,contextId, config); var focusElement = SFDom.getElementsByClassName("content", "", "sfOverlayMgr"); if(focusElement[0]) { focusElement[0].setAttribute("tabindex", "0"); focusElement[0].setAttribute("role", "note"); SFDom.setFocus(focusElement[0].id); } } function hideMFieldDialog(contextId){ SFInfoInContext.hide(contextId); } function handleKeyDown(contextId, values, evt){ var key = SFDOMEvent.getKeyName(evt); switch (key) { case "RETURN" : case "SPACEBAR" : SFDOMEvent.preventDefault(evt); showMFieldDialog(contextId, values, { refocusId : contextId, closeOnEsc : true }); break; } }

Requisition ID 24830 - Posted

02 / 13 / 2025 - CareOregon - Full Time - Permanent - Portland - Multi Location (18)

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Candidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.

Job Title

Provider Data Supervisor

Exemption Status

Exempt

Department

Claims

Manager Title

Claims Manager

Direct Reports

Provider Data Staff

Requisition #

24830

Pay and Benefits

Estimated hiring range $79,430 - $97,080 / year, 5% bonus target, full benefits. www.careoregon.org / about-us / careers / benefits

Posting Notes

This is a fully remote role, but you must reside in one of the listed 9 states.

Job Summary

This position is responsible for leading the daily operations of the provider data team in support of organizational needs and in compliance with state and federal requirements. Primary responsibilities include technical supervision, planning, communications, people leadership and technical assistance.

Essential Responsibilities

Technical Supervision

Supervise daily operations of provider data activities.

Provide reporting on current inventory and provide strategies for managing inventory to meet operational SLAs.

Assist in the development of new reporting to help the department track productivity and quality metrics.

Incorporate best practices for the business unit.

Coordinate all activities related to the planning, implementation, and operation of QNXT as it relates to provider data.

Oversee provider database maintenance activities, including data entry, process administration, queue monitoring, quality customer service and problem resolution.

Develop and monitor effective processes to ensure provider database integrity and accuracy.

Coordinate data integrity projects, working with internal customers and assigning staff as needed to make updates to QNXT provider file and workflows in support of data submission to regulatory bodies and provider directories.

Guide staff in provider data reporting for internal business partners and regulatory entities.

Monitor and track team metrics through the creation of monthly quality and productivity reports.

Coordinate the compilation and submission of state and federal required provider data reporting such as OHA DSN capacity report and CMS Network Adequacy.

Lead in the development and implementation of provider data policies and procedures.

Create and oversee the maintenance of detailed standard operating procedures for all essential functions of the position.

Planning

Approve staff scheduling and work assignments and coordinate coverage during times of absences and increased workload.

Create and manage a schedule of required reporting, develop project plans that efficiently monitor supporting activities to ensure compliance with reporting deadlines.

Manage resources to ensure work and project success.

Provide input into long-term planning and appropriate levels of staffing

Provide functional unit with ongoing understanding of the strategic and operational direction of CareOregon.

Communications

Establish and maintain cooperative and productive working relationships with internal and external customers.

Coordinate the provider data team's communication with external customers regarding provider information, provider status, claims administration as it relates to provider set-up, and responses to changes in the business or regulatory environment.

Coordinate the provider data team's communication with internal and external customers as it relates to provider data and responses to changes in the business or regulatory environment.

Serve as key internal contact on QNXT provider systems issues, upgrades, and emergent business needs; coordinate changes in work practices and procedures with provider configuration staff and ensure documentation accurately reflects current work environment.

Coordinate responses to internal and external (e.g., OHA, CMS, etc.) audits.

Represent provider data team on Network Adequacy Steering Committee and identify issues; make recommendations about provider network capacity and adequacy in each CareOregon service area.

Participate in leadership of QUsers Group Provider Data Workgroup.

Technical Assistance

Serve as QNXT provider data subject matter expert with internal customers including, but not limited to, Network & Clinical Support, QI / Credentialing, and IS / Development.

As escalated, audit provider database and online provider directory to ensure compliance with written documentation.

As needed, perform technical work with staff, including the following :

Research internal and external data sets, validate data and determine the correct course of action in case of data discrepancy / anomalies

Conduct analyses of provider-related new and existing products and business units.

Create, research, and send reports

Perform analyses and identify database solutions using tools such as Excel and SQL

Communicate with internal partners to document data requirements and transform into specifications for development

Consult with Provider Services, Operations leadership, users, stakeholders, and external vendors to define and document business requirements for reporting provider data

Ensure maintenance of documented variable criteria and logic used to produce provider data reporting, including the provider directory

Employee Supervision

Supervise team and recommend team direction and goals in alignment with the organizational mission, vision, and values.

Identify work and staffing needs to meet work expectations; recruit and hire, using an equity, diversity and inclusion lens.

Plan, organize, schedule, and monitor work; ensure employees have information and resources to meet job expectations.

Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.

Train, supervise, motivate and coach employees; provide support toward employee development.

Incorporate guidance from CareOregon equity tools into people leadership, planning, operations, evaluation and decision making.

Ensure team adheres to department and organizational standards, policies and procedures.

Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).

Perform supervisory tasks in collaboration with Human Resources as needed.

Organizational Responsibilities

Perform work in alignment with the organization's mission, vision and values.

Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.

Strive to meet annual business goals in support of the organization's strategic goals.

Adhere to the organization's policies, procedures and other relevant compliance needs.

Perform other duties as needed.

Experience and / or Education

Required

Minimum 4 years' experience with provider data management in a managed care or insurance environment, including experience leading projects

Preferred

Minimum 1 year experience in a supervisory or lead position or completion of CareOregon's Aspiring Leaders Program; lead roles preferably include regular assistance to a manager or supervisor in staff hiring, coaching, performance evaluation, and other supervisory tasks

Knowledge, Skills and Abilities Required

Knowledge

Excellent knowledge of relational databases

Excellent understanding of managed care, Medicare, and Oregon Health Plan concepts

Understanding of database construction

Knowledge of computer programming concepts and practices

Knowledge of GeoAccess Reporting preferred

Skills and Abilities

Strong analytical and research skills; able to see patterns in data and draw logical conclusions

Ability to interpret contract language

Advanced skills in claims processing technologies, such as QNXT and Facets

Advanced skills in document management and collaboration platforms such as SharePoint

Advanced skills with Microsoft products, including Access, PowerPoint, Excel, Word, and Outlook

Ability to participate in the development and monitoring of policies and procedures

Advanced skills in troubleshooting data integrity issues and root cause

Excellent communication skills and presentation skills

Ability to clearly articulate policies, instructions, goals, and objectives

Expert ability to author and maintain process documentation

Ability to convey appropriate level of detail to all levels of the organization including non-technical staff and senior leadership

Ability to effectively collaborate with coworkers, staff, and leaders across all departments

Excellent ability to network and use internal and external resources

Leadership skills, including the ability to train, coach and supervise staff

Ability to effectively delegate and coordinate tasks for multiple people and projects

Advanced ability to handle multiple and competing priorities and requests

Project management skills and ability to meet deadlines

Ability to proactively work to build and improve the department

Able to develop and implement solutions and communicate business value

Possess a high degree of initiative, motivation, and professionalism

l...

Salary : $79,430 - $97,080

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