Provider Roster Process Manager (Hybrid - Troy, MI) - Health Alliance Plan
🔍 Troy, Michigan
GENERAL SUMMARY:
The Roster Manager role includes maintaining and managing the accurate information of healthcare providers within a network, ensuring their details are up-to-date, compliant with regulations, and readily accessible for patient access and billing purposes. Their role will utilize multiple dedicated software systems to streamline the process and facilitate efficient provider network data roster management. The primary responsibilities of the role will entail planning, organizing, directing, evaluating and coordination of roster data management as it relates to key Health Alliance Plan’s (HAP) initiatives and provider service excellence within the Provider Network Management team. The ideal candidate should have extensive knowledge of the general regulatory guidelines for all lines of businesses within Michigan, to include Medicare, Commercial and Medicaid and industry best practices. They should be willing to work independently and collaboratively with cross-functional teams to ensure timely and accurate data delivery. The candidate should also be detail-oriented with strong written and verbal communication skills.
PRINCIPLE DUTIES AND RESPONSIBILITIES:
- High level oversight of rosters supplied by assigned provider partners, to include end-to-end management of workflow from receipt through effectuation into appropriate data systems.
- Facilitation between HAP and providers on roster submissions within multiple avenues of delivery systems.
- Perform data entry and cleaning activities, including discrepancy management and query resolution.
- Conduct data validation checks and implement quality control measures to ensure accuracy and completeness.
- Develop and execute standard operating procedures for roster management and multidepartment communications/facilitation.
- Collaborate with providers to resolve data-related issues and discrepancies within a roster while maintaining data accuracy.
- Contribute to the validation of data management software tools that are used when adding/terming/updating providers. Other key activities include project management, process improvement opportunities and being a SME for new system implementations.
EDUCATION/EXPERIENCE REQUIRED:
- Bachelor’s degree in a scientific or healthcare-related field.
- 2-4 years of experience in provider roster data management.
- Strong understanding of data pieces needed for Medicare, Commercial and Medicaid providers as outlined by regulatory agencies.
- Knowledge of industry-standard data analysis and reporting software, such as Power BI, Excel and others, is preferred.
- Excellent attention to detail with problem-solving and analytical skills.
- Strong organizational and time management abilities.
- Strong written and verbal communication skills.
Additional Details
This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above.
Overview
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services – from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford’s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation’s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at henryford.com/careers.
Benefits
The health and overall well-being of our team members is our priority. That’s why we offer support in the various components of our team’s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.
Equal Employment Opportunity/Affirmative Action Employer
Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is
committed to the hiring, advancement and fair treatment of all individuals without regard to
race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,
weight, marital status, family status, gender identity, sexual orientation, and genetic information,
or any other protected status in accordance with applicable federal and state laws.