Job details

Manager, Provider Operations

Arcadia is dedicated to happier, healthier days for all. We transform diverse data into a unified fabric for health. Our platform delivers actionable insights for our customers to advance care and research, drive strategic growth, and achieve financial success. For more information, visit arcadia.io.

Why This Role Is Important To Arcadia

As the Manager of Provider Operations you will lead your staff to an exceptional performance level by giving quality objectives and opportunities to expand their knowledge of services, products, and troubleshooting techniques which will focus on improving performance and processes in an effort to better support customers and internal department procedures.

What Success Looks Like

In 3 months

Train in the different areas of Provider Operations
Maintain the ability to accurately enter provider records manually into the system and meet the following expectations:
Quantity: 45 provider record adds or 55 provider record updates per day
Quality: monthly average of 95% or greater on the weekly audits
Conduct internal meetings with staff and other departments
Set goals and workflow patterns
Actively and consistently participate in the VBS Policy Committee

In 6 months

Understand the different areas of Provider Operations and train on the Provider Add Module
Maintain the ability to accurately enter provider records into the system and meet the following expectations:
Manual Entry:
Quantity: 55 provider record adds or 75 provider record updates per day
Quality: monthly average of 96% or greater on the weekly audits
Entry through Provider Add Module:
Quantity: 65 provider record adds
Quality: monthly average of 96% or greater on the weekly audits
Understand the different aspects and requirements of the different clients
Bring ideas and workflow changes to the table
Effectively understand most aspects of the Commercial & Medicare Advantage reporting
Work on higher level system enhancements
Coach and mentor success within the team

In 12 months

Be an expert on the different areas of Provider Operations.
Maintain the ability to accurately enter provider records into the system and meet the following expectations:
Manual Entry:
Quantity: 75 provider record adds or 100 provider record updates per day
Quality: monthly average of 98% or greater on the weekly audits
Entry through Provider Add Module:
Quantity: 100 provider record adds
Quality: monthly average of 98% or greater on the weekly audits
Be an expert on the different aspects and requirements of the different client’s provider records and contracts
Will be able to enhance workflows and understand the overall required outcomes.
Subject Matter Expert in Value Based Services

What You'll Be Doing

Determine the Provider Operations Departments operational strategies by conducting assessments, capacity planning, and cost/benefit analyses; identifying and evaluating state-of-the-art technologies; defining user requirements; establishing technical specifications, and production, productivity, quality, and data entry standards; contributing information and analysis to organizational strategic plans and reviews with standard auditing and reporting performance metrics
Maintains and improves Provider Operations processing operations by monitoring system performance; identifying and resolving problems; preparing and completing action plans; managing system and process improvement and quality assurance programs
Assessing and assigning workflow, coaching, counseling, and disciplining employees; administering scheduling systems and processes; communicating job expectations; planning, monitoring department measures; conducting staff performance conversations; enforcing policies and procedures
Responsible for assisting with monthly reporting submission requirements as outlined by the Health Plan
Responsible for completing client reporting requirements and capitation processes
Coordinate operational activities with other internal functions alongside departments and managers
Conduct at minimum monthly meetings with staff and attend operational meetings as requested
Conduct at a minimum monthly one on ones with individual staff and annual personnel reviews on staff performance
Attend client facing meetings as requested to discuss department statistics and measures
Other duties and responsibilities as assigned

What You'll Need To Have

2-4 years of management experience in Healthcare insurance platforms
Proficient with Microsoft programs (Word, Excel and Access) at an intermediate to advanced level
Must be organized, self-motivated, detail oriented, disciplined and a team player
Demonstrates the ability to manage staff and multi-task with minimum supervision and the ability to prioritize appropriately
Ability to teach and educate others in a manner that best suites the staff
Ability to meet deadlines and prioritize tasks; to effectively interact with operational and clinical personnel; collect, correlate and analyze data
Excellent written and oral communication

Would Love For You To Have

Contract and Provider management, Claims processing experience, HMO Managed care and Medical Advantage preferred.
Microsoft Access experience level – Advanced

What You'll Get

Learn the life of a Contract Management firm with Independent Physician Associations across Illinois.
Encouragement to bring ideas to the table.
Become an expert in leading the Provider Operation team.
Receive cash compensation with health, dental, and other benefits.
Be a part of a mission driven company that is transforming the healthcare industry by changing the way patients receive care
A flexible, remote friendly company with personality and heart
Employee driven programs and initiatives for personal and professional development
Be a member of the Arcadian and Barkadian Community

About Arcadia

Arcadia.io helps innovative healthcare systems and health plans around the country transform healthcare to reduce cost while improving patient health. We do this by aggregating massive amounts of clinical and claims data, applying algorithms to identify opportunities to provide better patient care, and making those opportunities actionable by physicians at the point of care in near-real time. We are passionate about helping our customers drive meaningful outcomes. We are growing fast and have emerged as the market leader in the highly competitive population health management software and value-based care services markets, and we have been recognized by industry analysts KLAS, IDC, Forrester and Chilmark for our leadership. For a better sense of our brand and products, please explore our website, our online resources, and our interactive Data Gallery.

This position is responsible for following all Security policies and procedures in order to protect all PHI under Arcadia's custodianship as well as Arcadia Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.

Arcadia.io Glassdoor Company Review

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CEO of Arcadia.io

Michael Meucci

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By Arcadia.io

Arcadia is an American heathcare software company committed to transforming data into powerful insights and actions that accelerate healthcare transformation. Arcadia is used by the nation’s leading healthcare providers.

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