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Claims Management - Provider Network Supervisor

Virtual Req #682
Wednesday, October 13, 2021

Our goals are to provide excellent service, utilize advanced technology, and proficiently deliver results. To accomplish these goals, we constantly seek individuals who look for ways to do things better. We are a company whose culture cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement.
 

Tabula Rasa HealthCare (TRHC) is a leader in providing patient-specific, data-driven technology and solutions that enable healthcare organizations to optimize performance to improve patient outcomes, reduce hospitalizations, lower healthcare costs, and manage risk. Medication risk management is TRHC’s lead offering, and its cloud-based software applications, including EireneRx® and MedWise™, provide solutions for a range of payers, providers and other healthcare organizations.

 

TRHC empowers our employees to provide excellent service, utilize advanced technology, and proficiently deliver results. Our 32Fundamentals are what we are and who we are.  Our culture cultivates teamwork, rewards excellence, focuses on quality for every aspect of our business, and promotes community involvement. As a part of our team, you will help us bring innovative service models to healthcare, improving patient outcomes.

Job Description:                       Provider Network Supervisor

 

Summary:

Under the supervision of the Assistant Director of Configuration and Provider Network Services, the Provider Network Supervisor is responsible for providing daily supervision and leadership to the team of Provider Network Specialists. The Provider Network Supervisor is responsible for directing workflows, identifying and resolving issues and developing and generating reports to improve efficiencies of the team.

 

Essential Functions:

  • Delegates work to the Provider Network team, tracks progress, evaluates performance and provides constructive feedback
  • Serves as the liaison between the Provider Network team and upper management
  • Approves timecards and PTO requests
  • Creates motivational, productivity-boosting strategies for the Provider Network team
  • Develops and reports metrics to improve efficiencies
  • Guides, trains and supports the team
  • Addresses problems with work quality, issues between employees and other concerns in an effective, timely manner

 

Additional Functions:

  • Assists with special projects, as requested
  • Attends client meetings, or other meetings, as requested
  • Communicates clearly and concisely, with sensitivity to the needs of others
  • Maintains the confidentiality of all company procedures, results, and information about participants, clients, providers and employees
  • Maintains courteous, helpful and professional behavior on the job
  • Establishes and maintains effective working relationships with co-workers
  • Ensures customer satisfaction by understanding and applying the Customer Service Policy, Procedure and Standards
  • Follows all Policies and Procedures and HIPAA regulations
  • Maintains a safe working environment

 

Supervisory Responsibility:

Responsible for daily supervision of the Provider Network Specialists

 

Travel:

None

 

Knowledge, Skills and Abilities:

  • Educational requirements include a High School Diploma or equivalent. Two years of professional work experience in a Health Plan Management setting in a similar role is required; prior supervisory experience is strongly preferred.
  • Experience analyzing and interpreting provider contracts
  • Working knowledge of provider records, fee schedules and payment methodologies
  • Knowledge of medical terminology
  • Knowledge of medical claims processing
  • Knowledge and experience using current computer technology, and a strong knowledge of Excel and Microsoft Word.
  • Skilled in establishing and maintaining effective working relationships with clients, and staff at all levels
  • Skilled in data analysis and problem solving using defined methodologies
  • Skilled in problem resolution; recommends suggestions to increase accuracy and/or efficiency
  • Ability to serve as a champion for the TRHC 32 fundamentals
  • Ability to work independently with minimal supervision
  • Ability to independently follow through on projects
  • Ability to communicate professionally, clearly and effectively, verbally and in writing
  • Ability to prioritize effectively
  • Ability to consistently multi-task

 

Physical Demands & Requirements:

  • Communicate by way of the telephone with participants, customers, vendors and staff
  • Operate a computer and other office productivity machinery, such as a calculator, copy machine, fax machine and office printer
  • Remain stationary for extended periods of time
  • Occasionally exert up to 20 pounds of force to lift, carry, push, pull or move objects
  • Visual acuity to perform activities such as identifying, inputting and analyzing data on a computer terminal and/or in hard copy
  • Occasional reaching to retrieve shelved items
  • Occasional bending/stooping

 

Work Environment:

  • This job operates in a professional or home office environment with a conversational noise level
  • No substantial exposure to adverse environmental conditions is expected
  • Moderate pressure to meet scheduled appointments and deadlines

 

***This is a remote position. Adequate internet speeds and a suitable home-office environment are required for this position. All new team members will be bound by the “Teleworking Agreement’ and must continually meet the terms of the agreement to maintain remote work status.

 

Tabula Rasa HealthCare, Inc. is an Equal Opportunity Employer.

 

Employment is contingent upon a successful background/drug check.

The Company is proud to be an equal opportunity employer. All qualified applicants will receive consideration without regard to ancestry or national origin, race or color, religion or creed, age, disability, AIDS/HIV, gender, marital or family status, pregnancy, childbirth or related medical conditions, genetic information, military service, protected caregiver obligations, sexual orientation, protected financial status or other classification protected by applicable law.

Other details

  • Pay Type Salary
  • Travel Required No
  • Travel % 0
  • Telecommute % 100
  • Required Education High School
  • Job Start Date Wednesday, October 13, 2021