Manager I Network Data - Brentwood - job 1197253

Date: 09/12/2021

City: Brentwood, Tennessee

Employment type: Full-time


SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At AIM Specialty Health (AIM), a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

Manager I Network Data

Location: Brentwood, TN- virtual start, office based

The Manager I Network Data is accountable for the end to end accuracy of myNEXUS provider data and maintenance of supporting all Provider data. The Manager is responsible for data review, validation, and loads into the myNEXUS system. The Manager oversees a team of staff who accomplish data entry, records maintenance, system configuration, reporting and problem solving. Close oversight of the validity and accuracy of provider data is central to assuring that our members have access to needed care.

Primary duties may include, but are not limited to:

  • Oversees all aspects of provider load/audit, troubleshooting, and all aspects of the provider table.
  • Hires, trains, coaches, counsels, and evaluations the performance of direct reports.
  • Analyzes and data-loading into the myNEXUS system.

  • Maintains rosters and provider affiliations for contracted groups, & other umbrella entities.

  • Conducts ongoing provider data validation and quality assurance audits.

  • Maintains configuration of Provider Data Management system & relationship with system vendor.

  • Provides technical expertise to staff as well as establishes workflows, quality validation and communication structures and ensures that work is in line with standards and regulations.

  • Develops and maintains Policies and Procedures for Provider Data Management work.

  • Responsible for end to end accuracy and completeness of provider data and supporting documentation.

  • Resolves issues encountered during daily operations and determines standards for problem resolution.

  • Serves as subject matter expert on provider data, related processes and systems used to meet regulatory, contractual and accreditation requirements.


Minimum Requirements:

Requires a BA/BS degree in related field; 2-3 years management and project management experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Qualifications:

  • Familiarity with provider data, including required data elements required for mandatory regulatory and client-based reporting on providers.

  • Salesforce experience.

  • Smartsheets experience.

  • Demonstrated proficiency with MS Office suite including Word, Excel, Outlook.

  • Exceptionally organized, process thinker able to oversee efficiency and accuracy of large-scale efforts.

  • Excellent written and verbal communication skills.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

How to apply:

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