Director, Provider Data and Configuration Teams

Title: Director, Provider Data and Configuration Teams

Summary:

CEI s healthcare client is adding a highly skilled and motivated Remote Director, Provider Data and Configuration Teams to their team based out of Bakersfield, CA. Under general supervision, you will provide strategic direction and oversee the system configuration and daily activities of the provider data and configuration teams, with a specific focus on QNXT and JIVA systems. Your role involves developing and managing healthcare-related configuration efforts according to best practices, internal and external requirements, and in support of organizational strategies.

Job at a glance:

• 6-month contract with possible conversion to direct hire
• $85-$95 /hr. W2
• This is a remote position, but candidates must reside in California.
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Responsibilities:

• Manage a team of Configuration Managers and Configuration Analysts.
• Develop, plan, and execute strategies for system configuration, ensuring effective integration with organizational goals.
• Monitor system performance and take appropriate action to maintain optimal function.
• Collaborate with internal stakeholders to ensure systems are configured in alignment with Medi-Cal and contract requirements.
• Lead the development and implementation of department goals and action plans.
• Oversee and monitor configuration-related projects, evaluating priorities, and making adjustments as needed.
• Meet regularly with direct reports to review project status and provide guidance.
• Develop tools and standard processes to track and measure the achievement of project-based goals and objectives.
• Review and approve system changes and enhancements, ensuring compliance with project specifications.
• Develop and implement policies and procedures to support system configuration integration.
• Oversee the creation and execution of training programs to optimize system configuration performance.
• Lead the development and implementation of audit programs to ensure compliance and efficiency.
• Provide direction on DMHC, DHCS APLs/OILs, and Medi-Cal policy updates to ensure system compliance with regulations.
• Promote and maintain an environment that aligns with the organization s strategy, vision, mission, and values.
• Hire, develop, and supervise an effective and competent team.

Qualifications:

• In-depth knowledge of managed healthcare systems, medical administration, and managed care industry processes.
• Strong understanding of Medi-Cal contract rules, regulations, benefits, and reporting requirements.
• Experience with QNXT and JIVA systems
• Proficiency in managing complex projects and systems, particularly in a managed care or healthcare environment.
• Excellent assessment, analytical, and strategic planning skills.
• Strong financial acumen and the ability to make informed business decisions.
• Ability to manage complexity and make sound decisions under challenging circumstances.
• Exceptional networking, collaboration, and communication skills, both oral and written.
• Strong project management skills with a proven ability to lead organizational-wide projects to successful completion.
• Intermediate proficiency in Word, Excel, and Outlook.
• Ability to maintain confidentiality and handle sensitive information with discretion.
• Bachelor s Degree in a related field.
• At least five years of experience analyzing and enhancing automated claims systems in a managed care environment.
• Minimum of five years of management experience in a configuration environment.
• At least three years of relevant project management experience, preferably in a managed care/healthcare environment.
• Other Requirements:
  • Valid California driver s license and reliable transportation or the ability to obtain transportation on demand within the counties served by the organization if prohibited from obtaining a driver s license due to a medically documented disability.
  • Availability for travel up to 5%.

CEI delivers solutions that help our customers transform their businesses and achieve meaningful results as a trusted technology partner. From strategy and custom application development through application management - our technology and digital experience services are tailored to meet each unique need of our customers. Our staffing solutions bring specialized skills to complement our customers' workforce and project requirements.