Team Manager | Healthcare | Credentialing | Claims Processing/Provider Data Management
Sutherland Global Services
About Sutherland: Artificial Intelligence. Automation. Cloud engineering. Advanced analytics. For business leaders, these are key factors of success. For us, they’re our core expertise. We work with iconic brands worldwide. We bring them a unique value proposition through market-leading technology and business process excellence. We’ve created over 200 unique inventions under several patents across AI and other critical technologies. Leveraging our advanced products and platforms, we drive digital transformation, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless “as a service” model. For each company, we provide new keys for their businesses, the people they work with, and the customers they serve. We tailor proven and rapid formulas, to fit their unique DNA. We bring together human expertise and artificial intelligence to develop digital chemistry. This unlocks new possibilities, transformative outcomes and enduring relationships. Sutherland Unlocking digital performance. Delivering measurable results Sutherland is looking for a talented Associate Manager to support one of our growing Healthcare programs! If you have the leadership skills along with healthcare domain experience, we want to hear from you! As an Associate Manager you will get to: Supervise the daily operations of the Credentialing team, including workload distribution, performance management, and staff development Ensure provider demographic and credentialing data is accurately entered and maintained in all systems Drive the performance of the team, by monitoring productivity, quality, and turnaround time standards Provide coaching, mentoring, and performance feedback to team members Manage attrition, shrinkage, and other critical metrics of the team. Support projects involving system enhancements or process automation Ensure credentialing activities are completed in accordance with applicable regulatory requirements, accreditation standards, health plan policies, contractual requirements, and established service-level agreements Identify and resolve credentialing issues, discrepancies, and exceptions, escalating complex matters as appropriate Ensure appropriate primary-source verification and documentation are completed and maintained in accordance with established requirements Our most successful candidates will have: 2+ years’ experience leading a team within the healthcare domain - experience with Credentialing. (Knowledge of Claims processing or Provider data Management can be an advantage!). Must be Team Manager University certified Open availability Abilityto work in MS Office and other program-specific platforms Ability to work in a fast-paced environment The ability to be pro-active in developing trust and professional rapport with employees and team members; work as a team-player Strong analytical skills; be able to interpret data, identify trends, and make suggestions for improvements Strong verbal and written communication skills; be able to communicate in a clear, constructive, and professional manner All your information will be kept confidential according to EEO guidelines. EEOC and Veteran Documentation During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status. At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file. Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION. #J-18808-Ljbffr Sutherland
$3,000 - $4,999 per month
Career Opportunities: Provider Recoupments & Holds Team Lead (20857)... ...Services Comm - Provider Claims Svcs (75/25) - Healthcare Support - Eligible... ...to the PRH Manager and performs advanced... ...and analyze data; update and maintain... ...and Analysis (30%). Processes complex cases including...DataClaimsFull timeTemporary workPart timeWork experience placementWork at officeRemote workShift work$54.43k - $81.65k
...takes an entire team of passionate and... ...Health provides an opportunity to... ...be comfortable managing a self-directed... ...authorization, claims, encounter data, eligibility, provider... ...obtain provider credentialing; utilize network... ...08-Ljbffr E2E Alignment Healthcare USA, LLCDataClaimsRemote jobMonday to FridayAfternoon shiftEarly shift- ...leading force in healthcare administration, on... ...are dedicated to providing innovative,... ...and experienced Claims Team Lead who acts with... ...crucial role in managing our claims environment... ...Lead for Claims Processing bridges Claims Processors... ..., and data entry. Critical...DataClaimsLive outRemote work
- ...seeks a Program Specialist V for the Provider Recoupments and Holds unit. Some... ...site work required. This role conducts data analysis on LTC authorizations, claim payments, holds, and recoupments. The position reports to the PRH Manager and requires strong Excel skills, policy...DataClaimsRemote work
- ...States Billing provides advanced... ...Revenue Cycle Management (RCM)... ...solutions that help healthcare providers... ...complex billing processes so providers... ..., coding, claims submission,... ...R recovery, credentialing, compliance,... ...and internal teams to reduce... ...credentialing data as needed. Day...DataClaimsFull timePart timeWork from home
- ...The Director of Credentialing provides strategic... ...implements the processes, service standards... ..., and team structure needed... ...state specialty healthcare organization.... ...Credentialing Manager and credentialing... ...provider master data, and... ...coverage changes, claims-history documentation...DataClaimsFull timeFor contractorsLocumWork at officeRelocationFlexible hours
- ...environment. At Sonic Healthcare USA, we emphasize... ...company that values its team members! Multi-tasking... ...monitoring staff. Provide patients, clients, and... ...center environment. Process billing claims, analyze accounts, and... ...and processing Data entry experience in a...DataClaimsFull timeWork at officeLocal areaShift workDay shift
$72.7k
...Lead with strong data-testing leadership and healthcare domain expertise... ...guide technical teams, and translate complex... ...Guide test data management and apply... ...expertise: Understand claims, membership, provider, and care management... ...business processes and regulatory quality...DataClaimsFor contractorsLocal areaRemote work$18.92 - $23.46 per hour
...to Work Modern Healthcare" - Join a team where people come... ...Perform duties to process referrals,... ...practice limits. Credentialing/re-credentialing... ...identify and audit claims, ensure all revenue... ..., follow up to provide the additional... ...for typing and data entry. Reaching...DataClaimsFull timeContract workTemporary workLocal areaImmediate startFlexible hours$55.89k - $73.36k
...Lead, Member and Provider Services to join our... ...is a provider data and production workflow... ...within a payor healthcare environment. This... ...workflows while driving team performance... ...will report into the Manager, Provider Data Operations... ...Lean Six Sigma or Process Improvement...DataFull timeWork at officeRemote workWork from homeHome office- ...highly qualified Program Specialist V in the Provider Recoupments and Holds unit. The role... ...authorizations, billing, hold, and recoupment processes, with partial telework and some on-site duties. The successful candidate will run data queries, update policies, train staff,...DataClaimsRemote job
- ...Community Clinic by providing dental care... ...of a care team to coordinate... ...families in self-management, self-efficacy... ...record chart data and service data... ...Federal Tort Claims Act.... ...work flow, work processes and patient care... ...registrations; CPR (Credentialing and...DataClaimsTemporary workPart timeWork at officeFlexible hours2 days per week3 days per week
- ...Health combines top-tier claims management with a compassionate, human-focused, data-driven care management... ...-insured employers provide care management that enables... ...smarter, cost-saving healthcare decisions. Continuous... ...renewal and contract process that leads to a...DataClaimsContract work
- ...Community Clinic by providing medical care... ...of a care team to coordinate... ...families in self-management, self-efficacy... ...record chart data and service... ...Federal Tort Claims Act. Participate... ...workflow, work processes, and patient care... ...Officer. (Credentialing and privileging...DataClaimsFull timeTemporary workFlexible hours
- Certified Provider Credentialing Specialist Cenpatico Behavioral... ...our commitment to managing behavioral healthcare services that can... ...simplifying the referral process for consumers.... ...service and claims payment for behavioral... ...of a credentialing team whose responsibilities...Claims
$20 - $25 per hour
...alternative application process. Practice Lead/... ...Time Ideal Eye Team- Wildflower Vision,... ...minimum supervision, provide lead support to the... ...performance to maximize Managed Vision Care... ...intake/checkout, and claims processing and collections... ...patient financial data, records, and files...DataClaimsHourly payFull timeLive inLocal areaRemote workWork from home- ...Company AI-enabled healthcare revenue cycle management company serving... ...billing and claims recovery.... ...Surprises Act and IDR process. The VP of Sales... ...leading the sales team but also... ...be a hands-on, data-driven leader with... ...within the company, providing valuable insights...DataClaims
- ...be met. Advanced data and analytics providing a comprehensive... ...employer-based healthcare plans. Our customized... ....-Effectively manages difficult client... ...and enrollment processes for assigned... ...larger service team.• Leadership-Mentors... ...service and/or claims management experience...DataClaimsWork at officeLocal area
$86.7k - $173.3k
...Abbott is a global healthcare leader that... ...Associate Product Manager – Global &... ...therapies allow us to provide interventional... ...and market data Perform market... ...marketing teams Offer leadership... ...key marketing claims across a wide variety... ...the FDA PMA process Learn...DataClaimsRemote workWorldwide- ...Ensemble is a leading provider of technology-... ...revenue cycle management solutions for... ...recognize that healthcare requires a... ...members of the team, not advisors.... ...trees, training data, and guardrails... ...risk to upstream process failures; test... ...systemic causes of claim edits,...DataClaimsPermanent employment
$102.5k - $184.5k
...to combine trusted data, AI, and... ...enterprise systems; teams that go from idea... ...financial services, and healthcare, and already running... ...and manufacturing processes to turn today's ideas... ...ongoing reference management. Identify and... ...customer data and claims. Why Join Siemens...DataClaimsRemote workShift work- ...collaboration, we equip our teams to work at the... .... The Acrisure Data Ontology... ...governance, master data management, and embedded subject... ..., underwriting, claims, and loss information... ...submission processes, and portfolio management... ...standards. Provide business definitions...DataClaimsFull timeImmediate startVisa sponsorshipFlexible hours
$126.3k - $173.7k
...our caring community The Provider CRM Lead (Lead Product Manager) is responsible for defining... ...enable a more connected, data-driven provider experience... ...analytics, and technology teams to improve provider engagement... ...wellness and smart healthcare decisions for you and your...DataFull timeTemporary workWork at officeRemote workWork from homeHome office- ...stratification process that incorporates data from available encounters, claims, lab, medication... ...coordination of quality healthcare services to meet... ...goals for self -management, teaching them... ...their physician team. Collaborate... ...physicians, providers, and practice staff...DataClaimsShift work
- ...production healthcare environment... ...of multiple team with Accenture... ...CDE (Clinical Data Exchange),... ...and mastery. Provide input into... ...in quality management reviews of the... ...certification in Claims, E&E,... ...neighboring credential Resolute PB... ...accommodation process. Accommodations...DataClaimsFull timeWork experience placementLive inWork at officeLocal area
$48.97k - $61.22k
...Place to Work Modern Healthcare” - Join a team where people come... ...to plan for and manage the Specialist... ...Supervise team in processing new patient... ...resolve missing claims reports and handle... ...Reimbursement Specialist to provide guidance,... ...ability to analyze data to identify actions...DataClaimsFull timeTemporary workWork experience placementLocal areaImmediate startFlexible hours$231k
...- Cloud Service Provider (TX)This role has... ...act on their data and applications... ...flexibility to manage our work and personal... ...-functional teams to bring compelling... ...and inspection processes, MEDDPICC qualification... ...verifying the credentials of any third party claiming to represent the...DataClaimsFull timeWork experience placementLocal areaImmediate startRemote workWork from home- ...and act on their data and... ...flexibility to manage our work and personal... ...experts, testing providers, certification... ...and operational processes.Coordinate certification... ...internal teams, subject matter... ..., digital credentials, localization,... ...any third party claiming to represent the...DataClaimsFull timeWork experience placementLocal areaImmediate startRemote workWork from home
$183.2k - $274.8k
...global leader in healthcare technology with... .... You will manage multiple concurrent... ...applications, data, commercial,... ...global matrixed teams, and strategic... ...transforming business processes, operating... ...suspicious message claiming to be from... ...of Medtronic to provide equal employment...DataClaimsFull timeH1bWork at officeLocal areaImmediate startRemote workFlexible hours- ...mission of providing exceptional... ...Acquisition Manager INTERPERSONAL... ...the executive team on workforce... ...with all healthcare-related employment... ...effective, data-driven... ...including clinical credentialing, pre-... ...enrollment processes in collaboration... ...Compensation claims, and safety...DataClaimsWork at officeLocal area
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