Job Description

Looking for a way to make an impact and help people?

Join PacificSource and help our members access quality, affordable care!

PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person’s talents and strengths.

Supervise and provide guidance to assigned team members regarding company policies, procedures, and workflow. Set goals and implement strategies to ensure team members are effectively assisting providers with internal processes. Responsible for hiring process of various Operations staff. Demonstrate effective leadership by coaching to improve individual performance and develop teamwork. Evaluate team member performance. Oversee provider data production and quality.

Essential Responsibilities:

• Maintain broad knowledge of all positions assigned to lead and develop programs to assure ongoing training and coaching to assigned staff.
• Supervise and evaluate data production and quality performance of team members. Conduct and submit performance evaluations on a timely basis.
• Conduct regular 1:1 with assigned staff
• Assist Manager in analyzing and determine staffing, training, and process improvement needs related to department goals.
• Assist manager in assessment, development, and oversight of department budget.
• Responsible for the creation, and evaluation of Operations production and data quality metrics to measure.
• Supervise creation around development and maintenance of Provider Network job aids, policies and procedures.
• Serve as liaison with all PacificSource departments to coordinate optimal provision of service and information.
• Attend and lead various enterprise workgroups related to provider data scalability and quality outcomes. Document and report any pertinent communications back to the manager, team, or department.
• Lead continuous improvement efforts for both enterprise and team processes to ensure department and company outcomes are met.
• Responsible for fostering a positive work environment (virtually and in person), offering constructive feedback and promoting continuous learning and department development goals.
• Work collaboratively with various PacificSource leadership teams to develop best practices and address issues across various enterprise wide processes.
• Responsible for hiring, staff development, coaching, performance reviews, corrective actions, and termination of employees.
• Investigate and settle issues with provider data as needed. Relay information for resolution to Manager, Director, appropriate departments, and personnel.
• Responsible for the oversight and compliance of provider data quality related to various regulatory and marketability standards. Including but limited to NCQA, OHA, CMS, WAOIC, etc.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

SUCCESS PROFILE

Work Experience: Minimum of three years of experience in closely related insurance field or three years’ supervisory experience required.

Education, Certificates, Licenses: Requires high school diploma or equivalent.

Knowledge: Effective written and oral communication. Ability to read, understand and communicate policies. Effective problem solving skills required. Requires ability to define and prioritize problems and manage workload without direct supervision. Ability to work under time pressures and heavy workloads. Ability to use judgment to make logical decisions that are consistent with company culture and philosophy. General computer, word processing and spreadsheet skills.

Competencies:

Building Trust

Building a Successful Team

Aligning Performance for Success

Building Customer Loyalty

Building Strategic Work Relationships

Continuous Improvement

Decision Making

Facilitating Change

Leveraging Diversity

Driving for Results

Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.

Skills:

Accountable leadership, Collaboration, Communication (written/verbal), Critical Thinking, Decision Making, Influencing, Listening (active), Organizational skills/Planning and Organization

Compensation Disclaimer

The wage range provided reflects the full range for this position. The maximum amount listed represents the highest possible salary for the role and should not be interpreted as a typical starting wage. Actual compensation will be determined based on factors such as qualifications, experience, education, and internal equity. Please note that the stated range is for informational purposes only and does not constitute a guarantee of any specific salary within that range.

Base Range:

$56,779.86 - $96,525.75

Our Values

We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:

• We are committed to doing the right thing.
• We are one team working toward a common goal.
• We are each responsible for customer service.
• We practice open communication at all levels of the company to foster individual, team and company growth.
• We actively participate in efforts to improve our many communities-internally and externally.
• We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
• We encourage creativity, innovation, and the pursuit of excellence.

Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.