Director of Provider Data Integrity and Program Management
3 weeks ago
Empower. Unite. Care.
MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.
About NYC Health + Hospitals
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
Reporting to the Vice President of Provider Network Operations, the Director of Provider Data Integrity and Program Management is responsible for ensuring the highest standards are met for accuracy, accessibility, and availability of the network, including oversite of various vendors. This position will collaborate with other functions on the development of Provider Key Performance Indicators (KPIs) to inform on performance and operational excellence of the network for both internal and external stakeholders. This position is also responsible for various
Network operational reporting and applications to support the daily workflow of Credentialing, Provider Relations and Provider Engagement activities.
Job Description
Develop and oversee all the functions of the Data Integrity and Program Management team.
Oversight of the vendors responsible for the quarterly accuracy & availability surveys, the annual Provider Satisfaction survey as well as data accuracy and adequacy.
Identify improvements to access and availability of the network and collaborate with various department to execute action plans.
In collaboration with Analytics, Quality Management, Claims and others, execute on the development and management of Provider KPI dashboard reporting.
Maintain compliance for Network adequacy, including Medicare requirements and the NY Medicaid PNDS submissions.
Develop and maintain Provider Relations and Credentialing activity reporting.
Identify opportunities for operational process improvements, increasing automation, reducing rework, and bringing about operational efficiencies to support an optimal Network Operations environment.
Act as a subject matter expert on Provider Data Management goals and strategies for operational excellence.
Develop PowerPoint Slide decks/self-serve tools to support QBRs and Operations meetings based on external KPI’s.
Program Management of Site Visits, Access & Availability (A&A), and Education tracking
Development and Coordination of all Provider P&Ps, Quality Committee submissions and Regulatory narratives., ensuring adherence to all Legislative, Regulatory and Contractual requirements.
Fosters a culture of accountability that emphasizes people and performance management, coaching and development and employee engagement.
Minimum Qualifications
Master of Public Administration (MPA) or Master of Public Health (MPH) degree required; and
Minimum 5 years of relevant healthcare industry experience in a provider network operations role; or
A satisfactory equivalent combination of education, training, and minimum 10 years of relevant healthcare industry experience in a provider network management and Provider Network Operations environment.
Must have excellent healthcare financial and operational data analysis and reporting skills.
A demonstrated track record of operational trend reporting in the day-to-day business of a high-volume. operations using current and new technology, achieving cost benefits and service excellence.
Experience creating dashboards, reporting metrics, synthesizing, and delivering key information with key stakeholders.
Professional Competencies
Integrity and Trust
Customer Focus
Functional/Technical skills
Written/Oral Communication
Proven track of building cross-functional relationships
Excellent verbal and written communications skills with demonstrated ability to communicate, present, and influence both credibly and effectively at all levels of an organization, including executive and Clevel.
Demonstrated ability to lead and develop people
Demonstrated self-starter, strategic thinker, and ability to work collaboratively in a team atmosphere.
Adapt quickly to change in an ever-changing environment.
Adaptable quickly to change in an ever-changing environment.
Strong business acumen, analytical and critical thinking
#LI-Hybrid
-
New York, United States MetroPlusHealth Full timeEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...
-
New York, United States MetroPlusHealth Full timeJob DescriptionJob DescriptionEmpower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health +...
-
Child & Adolescent Program Manager
3 weeks ago
New York, United States Violence Intervention Program, Inc. Full timePosition: Child and Adolescent Program ManagerDepartment: Child and Adolescent ProgramLocation (s): Citywide - all VIP locationsReports to: Director, Specialized ProgramClassification: Full Time - ExemptWork Model: HybridCompensation: $80,000 annually, non-negotiable# of positions: 1The Violence Intervention Program, Inc. (VIP) is the only culturally...
-
Executive Director
1 week ago
New York, United States Jeremiah Program Full timeABOUT JEREMIAH PROGRAMJeremiah Program (JP) is a nonprofit organization helping single mothers invest in themselves so they can thrive and take steps towards economic mobility by helping them access higher education, affordable childcare, housing, skills training and career development. JP envisions a world where poverty is no longer feminized; where race is...
-
Executive Director
2 weeks ago
New York, United States Jeremiah Program Full timeABOUT JEREMIAH PROGRAMJeremiah Program (JP) is a nonprofit organization helping single mothers invest in themselves so they can thrive and take steps towards economic mobility by helping them access higher education, affordable childcare, housing, skills training and career development. JP envisions a world where poverty is no longer feminized; where race is...
-
Executive Director
2 weeks ago
New York, United States Jeremiah Program Full timeABOUT JEREMIAH PROGRAMJeremiah Program (JP) is a nonprofit organization helping single mothers invest in themselves so they can thrive and take steps towards economic mobility by helping them access higher education, affordable childcare, housing, skills training and career development. JP envisions a world where poverty is no longer feminized; where race is...
-
Director of Development
2 weeks ago
New York, United States Harmony Program Full timeOrganizational Background At the Harmony Program, music changes lives every day. Through collective music-making, children from under-served communities explore new avenues and realize their full potential. For over 15 years, the Harmony Program has distinguished itself by serving children in need, reaching them within their own communities, providing them...
-
Data and Program Coordinator
1 month ago
New York, United States Urban Upbound Full timeJob DescriptionJob DescriptionFounded in 2004, the mission of Urban Upbound is to break cycles of poverty in public housing neighborhoods and other low-income communities in New York City. We advance our mission through five integrated programs: employment services, financial counseling, youth development services, community revitalization, and financial...
-
Provider Data Maintenance Analyst
1 month ago
New York, United States VIllageCare of New York Full timeExciting Opportunity: Join our team at VillageCare as a Full Time Provider Data Maintenance Analyst where you can showcase your analytical skills and contribute to the integrity of our provider database. This position offers the flexibility to work from home, allowing you to manage your workload efficiently while enjoying a comfortable work environment. With...
-
Program Director-Teen Center
2 weeks ago
New York, United States JCCs of North America Full timeThe Program Director for the Edgies Teen Center @ MCC is a high-impact leader responsible for the development, implementation, supervision, and evaluation of a high-quality afterschool program designed to provide meaningful enrichment opportunities to Lower East Side teens. Working closely with leaders across MCC and Educational Alliance, this Program...
-
New York, New York, United States Bank of America Full timeJob Description:At Bank of America, we are guided by a common purpose to help make financial lives better through the power of every connection. Responsible Growth is how we run our company and how we deliver for our clients, teammates, communities and shareholders every day.One of the keys to driving Responsible Growth is being a great place to work for our...
-
Wellness Program Director
3 days ago
New York, United States NYC Health Hospitals Full timeNYC Health + Hospitals/McKinney provides high quality short-term rehabilitation and long-term skilled nursing care in a comfortable person-centered setting. The McKinney Team commit themselves to the delivery of compassionate, comprehensive services in manner that promotes the dignity and respect of our residents. Each resident has a qualified and caring...
-
Director of Development
3 weeks ago
New York City, United States Harmony Program Full timeOrganizational Background At the Harmony Program, music changes lives every day. Through collective music-making, children from under-served communities explore new avenues and realize their full potential. For over 15 years, the Harmony Program has distinguished itself by serving children in need, reaching them within their own communities, providing them...
-
Family Medicine Residency Program Director
7 days ago
New York, New York, United States Provider Healthcare Full timeMultiple Sites, New York Job Type Full Time Pay $250,000 Annually Patients Per Day 18-22 EMR System - Proprietary Work Location Clinic Job ID 50927 Job Description A New York based client is searching for a highly motivated and goal-driven Family Medicine Residency Program Director to work in the Jamaica and Queens areas. An ideal candidate is an...
-
Family Medicine Residency Program Director
5 days ago
New York, United States Provider Healthcare Full timeMultiple Sites, New York Job Type Full Time Pay $250,000 Annually Patients Per Day 18-22 EMR System - Proprietary Work Location Clinic Job ID 50927 Job Description A New York based client is searching for a highly motivated and goal-driven Family Medicine Residency Program Director to work in the Jamaica and Queens areas. An ideal candidate is an...
-
Program Director
3 days ago
New York, United States Soloh Partners Inc Full timeThe Program Director is responsible for the overall operation of all HRA-HASA Scatter Site Housing Programs, which includes management of staff, overseeing the development and implementation of program enhancements, monitoring and compliance, evaluation of policies and implementing proper procedures for the program. The Program is characterized by a team...
-
Program Director
4 weeks ago
New York, United States Soloh Partners Inc Full timeThe Program Director is responsible for the overall operation of all HRA-HASA Scatter Site Housing Programs, which includes management of staff, overseeing the development and implementation of program enhancements, monitoring and compliance, evaluation of policies and implementing proper procedures for the program. The Program is characterized by a team...
-
Program Director
2 days ago
New York, United States Soloh Partners Inc Full timeThe Program Director is responsible for the overall operation of all HRA-HASA Scatter Site Housing Programs, which includes management of staff, overseeing the development and implementation of program enhancements, monitoring and compliance, evaluation of policies and implementing proper procedures for the program. The Program is characterized by a team...
-
Program & Evaluations Manager
5 hours ago
New York, United States Stone Alliance Group Full timeOur client is recruiting a **Program and Evaluations Manager **for Professional Training for the School and Community Programs. Breaking down barriers to care, the Professional Training team engages in collaborative relationships with school partners to build on strengths and increase capacity for sustainable access to mental wellness for students. These...
-
Director of Data Governance
2 weeks ago
New York, United States Focus Capital Markets Full timeWe are looking for a leader with past experience in building and implementing a data governance program in a technically innovative firm to optimize the value of our data assets and digital products that provide revenue-generating insights. In this role, you will oversee the strategy of data governance from its conception to implementation, creating unified...
