Senior Manager Provider Operations

Job Summary

Leading a hybrid onshore and offshore team, the full-time Senior Manager Provider Operations will be responsible for ensuring provider data accuracy and compliance, managing validation and verification processes, and shaping directory strategy to enhance care navigation tools in a remote environment.

Key responsibilities

• Own provider data accuracy through validation, verification, and compliance with CMS Medicare Advantage directory requirements
• Lead and grow a team focused on operational processes, quality assurance, and performance management
• Define metrics and reporting for provider data accuracy, delivering insights to executive stakeholders and guiding strategic initiatives

Required qualifications

• Bachelor's degree and a minimum of 6 years of relevant experience, including at least 2 years in a management role
• Experience in healthcare operations with hands-on ownership of provider data and directories
• Knowledge of regulatory requirements governing provider directories and network adequacy
• Proficiency in analyzing data sets to generate actionable insights
• Demonstrated success in building operational processes with measurable quality outcomes