Supervisor Provider Network Operations
Amerihealth Caritas•,
•Remote
About The Position
The Provider Network Operations Supervisor supports the daily operations of the Provider Network Operations team by overseeing staff performance, ensuring operational efficiency, and maintaining compliance with internal policies and contractual requirements. This position is fully remote and requires the candidate to be located in Michigan (MI). The role also requires reliable high-speed internet (minimum 50 Mbps download / 5 Mbps upload), and internet reimbursement may be available where required by law or contract. Monthly meetings may be required in Southfield, MI.
Requirements
- Associate degree required or equivalent combination of education and relevant work experience
- Strong leadership and team development capabilities
- Knowledge of healthcare operations, particularly claims and provider data
- Analytical and problem-solving skills with attention to detail
- Ability to manage multiple priorities in a fast-paced environment
- Strong communication and interpersonal skills
- Ability to identify process improvement opportunities and drive change
Nice To Haves
- 1 to 3 years of supervisory or leadership experience preferred
- Experience in managed care or a healthcare environment preferred
- Knowledge of claims processing, coding, payment, and/or provider data operations strongly preferred
- Familiarity with Medicaid reimbursement methodologies preferred
Responsibilities
- Supervise, coach, and monitor staff performance to ensure quality and timely completion of work
- Support the Manager in implementing departmental initiatives and process improvements
- Ensure operational processes align with internal policies, contractual obligations, and service level agreements (SLAs)
- Oversee and support the resolution of provider inquiries and complaints, ensuring timely and effective outcomes
- Monitor provider data maintenance and/or claims-related activities, providing feedback and recommendations for improvement
- Research and resolve complex claims issues and operational discrepancies
- Identify operational challenges and recommend solutions to improve performance and compliance
- Participate in special projects and perform additional duties as assigned
Benefits
- Internet reimbursement may be available where required by law or contract
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
