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Mgr. Provider Registry Configuration

Company: Capital District Physicians' Health Plan, Inc
Location: Albany
Posted on: June 14, 2019

Job Description:

For more than 30 years, CDPHP has been providing outstanding health care coverage in the Capital Region of New York and beyond. Based in Albany, NY, the physician-guided not-for-profit offers plans in 24 counties. CDPHP cares deeply about the health and well-being of its members as well as its employees. The company values integrity, diversity, and innovation, and its corporate culture supports those values wholeheartedly. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

The Manager, Provider Registry Configuration will have the responsibility for the oversight, development and monitoring of implementation, monitoring and evaluation of all Provider Registry data and staff. Responsible for the strategic development, implementation, and monitoring of process efficiencies, technology, regulatory compliance, and product development as related to CDPHP provider reimbursement.

This individual works with management, developers and analysts to manage and configure the applications supporting CDPHP s core processes and functions for provider data. The Manager, Provider Registry Configuration is responsible for provider data deliverables associated with management, configuration and maintenance of CDPHP s Provider Registry systems and applications during their lifecycle, specifically with Facets and its integrated systems.

This individual will ensure that processes within the Provider Registry team are documented and followed. They will analyze business procedures, problems, and business requirements, and determine solutions. The Manager, Provider Registry Configuration is responsible for accuracy of company-wide provider data including data that impacts claims payment and directory information.


* Bachelor s degree required. 7 years relevant experience may be substituted for degree.

* Minimum five (5) years configuration and business analysis experience that includes: evaluation of business procedures and problems, feasibility studies, system configuration, configuration design, preparing detailed specifications for the development of business configuration and testing is required.

* A minimum of five (5) years experience in healthcare programs and processes and working with internal departments and external vendors is required.

* Experience in applying relational database concepts and techniques preferred.

* Previous management experience required.

* Knowledge of healthcare and HMO processes, rules, regulations, enrollment/eligibility guideline and reporting requirements for HMO, PPO, ASO, Medicare, Medicaid, Child Health Plus.

* Demonstrated ability to analyze, identify, implement and monitor outcomes required.

* Demonstrated ability to manage and shift priorities to meet project schedules.

* Ability to successfully work with an application management and development team in defining system implementation, conversion and configuration strategy.

* Proficiency in Microsoft Excel is required. Access and SQL experience preferred.

* Organizational skills and excellent written and verbal communication skills are required.

* Demonstrated ability to identify weaknesses in workflow and develop and implement process improvements to continually ensure that corporate goals are satisfied is required.

* Excellent interpersonal skills and a productive team player.

* Must possess strong analytical skills.

As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices due to an applicant s race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.

Keywords: Capital District Physicians' Health Plan, Inc, Albany , Mgr. Provider Registry Configuration, Other , Albany, New York

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