Provider Data Maintenance Team Leader

PacificSource Health Plans

. Supervise and guide assigned team members on company policies, procedures, and workflow .

Posted 9/24/2026full-timeRemote • North Carolina • United StatesSenior💰 $56,780 - $96,526 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong leadership and supervisory skills in managing operations staff, fostering teamwork, and implementing training programs. Proficient in evaluating performance metrics and ensuring compliance with industry standards while promoting a positive work environment.

Highest-signal resume keywords

Supervisory ExperiencePerformance EvaluationTeam DevelopmentCompliance with NCQA, OHA, CMS StandardsEffective Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data Quality MetricsProcess ImprovementGeneral Computer SkillsWord Processing SkillsSpreadsheet Skills

Soft Skills

Accountable LeadershipCollaborationCritical ThinkingDecision MakingActive Listening

Industry Keywords

Provider DataInsurance FieldHIPAA CompliancePacificSource PoliciesEnterprise Workgroups

About the role

Key responsibilities & impact

Supervise and guide assigned team members on company policies, procedures, and workflow
Set goals and implement strategies to ensure team members effectively assist providers with internal processes
Manage hiring processes for Operations staff
Coach employees to improve individual performance and develop teamwork
Evaluate team member performance and submit timely performance evaluations
Maintain knowledge of assigned positions and develop ongoing training and coaching programs
Supervise and evaluate data production and quality performance
Conduct regular one-to-one meetings with assigned staff
Assist the Manager with staffing, training, process improvement, and department budget assessment
Create and evaluate Operations production and data quality metrics
Supervise development and maintenance of Provider Network job aids, policies, and procedures
Liaise with PacificSource departments to coordinate service and information
Attend and lead enterprise workgroups related to provider data scalability and quality outcomes
Document and report relevant communications to management, teams, and departments
Lead continuous improvement efforts for enterprise and team processes
Foster a positive virtual and in-person work environment, provide constructive feedback, and promote continuous learning
Collaborate with leadership teams to develop best practices and address enterprise-wide process issues
Oversee hiring, staff development, coaching, performance reviews, corrective actions, and terminations
Investigate and resolve provider data issues, escalating information as needed
Oversee compliance and quality of provider data related to NCQA, OHA, CMS, WAOIC, and other standards
Meet department and company performance and attendance expectations
Follow PacificSource privacy policy and HIPAA confidentiality and security requirements
Perform other duties as assigned

Requirements

What you’ll need

Minimum of three years of experience in a closely related insurance field or three years of supervisory experience required
High school diploma or equivalent required
Effective written and oral communication
Ability to read, understand and communicate policies
Effective problem-solving skills
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 consistent with company culture and philosophy
General computer, word processing and spreadsheet skills
Accountable leadership, collaboration, communication, critical thinking, decision making, influencing, active listening, organizational skills/planning and organization
Ability to read and comprehend both written and spoken English
Ability to communicate clearly and effectively
Ability to stoop and bend, sit and/or stand for extended periods, perform repetitive typing/sorting/filing motions, and lift/carry files and business materials

Benefits

Comp & perks

Work from home designation (WFH: NC)
Virtual and in-person work environment
Equal opportunity employment
Approximately 5% travel
At-will employment