Manager, Data Operations

Allied Benefit Systems•Chicago, IL

1d•$80,000 - $100,000•Remote

About The Position

The Manager, Data Operations will be responsible for the implementation, integration, management, and delivery of data interchange with PBMs. The role will oversee the implementation and ongoing maintenance of PBM related processes including daily Rx claim files, medical accumulator files/questions related to, Rx data warehouse files, etc. The position will direct the day-to-day operations of PBM integrations including management, maintenance, reporting while developing and ensuring robust quality standards.

Requirements

Minimum of 5 years of experience in similar role preferably data operations in healthcare and/or insurance.
At least 3 years at a supervisor level and successfully demonstrated leadership competencies
Previous project management experience.
Required experience with the following applications: SQL, and Microsoft Power BI
Working knowledge of data management, data warehousing, and coding languages
Excellent knowledge of data integration program involving all components including source systems, ETL, data quality/integrity, database, and delivery mechanisms and EDI business processes, practices, and procedures within healthcare environment
Strong work-ethic and positive attitude and exceptional ability to manage multiple projects across functional teams in a fast-paced environment
Strong communication skills (both verbal and written) and an ability to provide recommendations on data integrations and applications
Strategic, conceptual analytical thinking and decision-making skills.
Ability to advise on complex technical matters to all stakeholders; ability to communicate effectively with senior management.
Accountability
Communication
Action Oriented
Timely Decision Making
Building Relationships/Shaping Culture
Customer Focus

Nice To Haves

Project Management Professional (PMP) certification desired

Responsibilities

Manages day to day operations and inquiries related to RxClaims data
Reviews, prioritizes, and assists with reported discrepancies in claims data, accumulators, and member complaints
Establishes SLAs for issue resolution and transparency on process
Establishes and maintains relationships with the PBMs that Allied has connections with
Oversees the daily processing of all inbound and outbound data processing
Manages Data Analysts
Demonstrates a strong understanding of the internal business needs and technical requirements
Develops and implements new data management audits and quality assurance protocols
Project manages PBM projects to completion
Establishes data connections with trading partners
Interfaces with Allied’s IT team on projects and data management strategies
Ensures all PBM file changes are executed correctly and timely
Builds strong, collaborative, cross functional teams and trusted business relationships
Acts as Allied’s internal and external point of contact for data management issues
Acts as a liaison between Allied’s internal team and external trading partners
Acts as an escalated point of contact for data management issues
Lead, coach, motivate and develop. Responsible for one-on-one meetings, performance appraisals, growth opportunities and attracting new talent.
Clearly communicate expectations, provide employees with the training, resources, and information needed to succeed.
Actively engage, coach, counsel and provide timely, and constructive performance feedback.
Work on special projects, duties or tasks as assigned.