Provider Supervisor Resume Samples

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Guide the recruiter to the conclusion that you are the best candidate for the provider supervisor job. It’s actually very simple. Tailor your resume by picking relevant responsibilities from the examples below and then add your accomplishments. This way, you can position yourself in the best way to get hired.

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D Berge

Devan

Berge

836 Schmitt Field

Dallas

+1 (555) 297 5334

836 Schmitt Field

Dallas

Phone

p +1 (555) 297 5334

Experience Experience

Philadelphia, PA

Provider Supervisor

Philadelphia, PA

Mosciski and Sons

Philadelphia, PA

Provider Supervisor

Assisting Data Manager in employee and contractor evaluations
Interacting with other CRM department personnel in problem resolution and process improvement
Providing direct and ongoing supervision of DACs with regard to conflict resolution and HR policy compliance
Evaluating processes and standard operating procedures to ensure work alignment and to challenge efficiency/effectiveness
Performing DAC-related function approximately 25% of the time
Attending leadership meetings and offering his/her perspective
Interacting with Stakeholders

Chicago, IL

Provider Enrollment Supervisor

Chicago, IL

Metz-Kunze

Chicago, IL

Provider Enrollment Supervisor

Educates, develops and assists subordinate management personnel to ensure performance and productivity standards are met
Identify recurring problems and provide feedback to management to affect change
Directs and develops subordinate staff. Interviews and selects subordinate management staff necessary to meet RCM goals and objectives
Assists internal associates will enrollment-related questions and issues
Evaluates the performance of subordinate personnel in a timely and effective manner
Oversees and approves the selection of non-management staff in the Corporate Patient Accounts departments
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties

present

Philadelphia, PA

Supervisor of Provider Installation

Philadelphia, PA

Trantow, Schuppe and Hoeger

present

Philadelphia, PA

Supervisor of Provider Installation

present

Review work performed by others and provide recommendations for improvement
Analyze information and utilize to build recommendations to reduce errors and improve process performance
Create, maintain and track reports in relation to performance
Assists the leadership team in the development and training of new processes and systems
Performs other related duties which may be inclusive
Manages escalated issues from internal and external sources
Provide coaching to staff

Education Education

Bachelor’s Degree in Employee Satisfaction

San Diego State University

Bachelor’s Degree in Employee Satisfaction

Skills Skills

Intermediate Ability to work in a fast paced environment with changing priorities Ability to work in a fast paced environment with changing priorities
Ability to multi-task Ability to multi-task
Intermediate Ability to multi-task Ability to multi-task
Intermediate proficiency in Microsoft Outlook, Word, Excel, and PowerPoint
Intermediate Ability to work within tight timeframes and meet strict deadlines
Intermediate - Ability to analyze information and covert related activities into a comprehensive work plan
Intermediate - Knowledge of healthcare delivery
Intermediate Ability to multi-task
Intermediate - Ability to multi-task
Intermediate Ability to represent the company with external constituents

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11 Provider Supervisor resume templates

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Provider Enrollment Supervisor Resume Examples & Samples

Screens, interviews, and hires applicants for the Provider Enrollment Specialists · Assists in the creation and accuracy of training for the Provider Enrollment Specialists · Updates Procedure Manuals · Assists in Operational Readiness Testing, as required · Supervises the Provider Enrollment Specialists and coordinates all provider enrollment activities including application processing, provider file changes, provider inquiry calls, and miscellaneous enrollment activities · Supervise Enrollment Department operations and monitor workflow daily · Act as primary contact for the Department · Communicates and attend meetings with the Department as needed to document and train staff on the provider enrollment process and procedures · Maintains the security and integrity of all paper documents and electronic files used for provider enrollment and credentialing · Trains the staff on all key components of the provider enrollment process and all tools associated with this process, i.e. – web portal, provider screening and verification, etc. · Monitors staff activities to meet or exceed standards of timeliness for the completion of provider application processing and provider file updates · Submit monthly reports for the Department as it relates to the service level agreements · Conduct coaching sessions on performance issues and document each session thoroughly with dates, examples and signatures · Conducts and/or provides input for staff performance reviews · Works closely with service center supervisors to identify and address provider enrollment issues · Provides guidance to a team of Provider Enrollment Specialists in a variety of duties including, but not limited to the following
Research enrollment issues to identify root causes and determine corrective action (s) to resolve issues, communicate findings, and document finding for future use
Request additional information needed to complete processing of enrollment request
Assists internal associates will enrollment-related questions and issues
Identify recurring problems and provide feedback to management to affect change
Responsible for credentialing providers
A High School diploma or GED equivalent diploma, with experience of at least
Three (3) to Five (5) years of supervisory experience
Two (2) to Three (3) years in the medical arena or healthcare field
Demonstrated knowledge and experience in the enrollment process
Proficient in Excel, Word and PowerPoint
Demonstrated ability to provide guidance and direction to staff
Ability to communicate effectively, both verbal and written

Supervisor of Provider Installation Resume Examples & Samples

Directs, supervises, coordinates specific functions and activities of the team, including systems, policies and procedures, human resources, support services, etc
Assists the leadership team in the development and training of new processes and systems
Cooperates with the regulatory requirements to ensure compliance with standards and regulations
Reviews operational problems / policies and recommends solutions and change to leadership
Recommends capacity modeling based on knowledge of policies, costs, and operating practices
Represents department in professional meetings
Performs other related duties which may be inclusive
Analyze information and utilize to build recommendations to reduce errors and improve process performance
Create, maintain and track reports in relation to performance
Serve as subject matter resource to team members, supervisors and management staff
Provide coaching to staff
Maintains an understanding of the roles and responsibilities of the staff and their functions, and executes those roles and responsibilities as needed
Manages escalated issues from internal and external sources
Special projects, initiatives, and other job duties as assigned
3+ years professional work experience
Previous experience with quality programs, process improvement initiatives, project management, training, reporting, auditing or similar functions
At least an intermediate proficiency in Microsoft Office suite, including Word, Excel, Outlook and PowerPoint
Previous experience in a subject matter expert (SME), team lead, supervisor and/or manager role
Previous experience with provider data (demographic and / or contractual)
Previous experience with claims processing systems such as FACETS, SCION/WONDERBOX
Previous experience with customer relationship management (CRM) tools such as Salesforce

Supervisor Provider Install Resume Examples & Samples

Coordinate work activities with other supervisors
Develop plans to meet short-term objectives
Product, service or process decisions are most likely to impact individual employees and / or customers (internal or external)
2+ year(s) supervisory or leadership role experience (including Team Lead or SME)
1+ year(s) experience with quality programs and process improvement initiatives
1+ year(s) inventory management experience
Medium proficiency in Microsoft Excel
3+ years’ experience with provider data (demographic and / or contractual)
1+ years’ experience with NDB
1+ year(s) experience with claims processing systems such as COSMOS, UNET and / or CSP
1+ year(s) experience with workforce effectiveness practices

Provider Supervisor Resume Examples & Samples

Assisting Data Manager in employee and contractor evaluations
Ensuring employee recognition
Attending leadership meetings and offering his/her perspective
Interacting with Stakeholders
Evaluating employee assets (computer, headsets, chairs, etc.) for availability, functionality and effectiveness
Interacting with other CRM department personnel in problem resolution and process improvement

Supervisor, Provider Operations Resume Examples & Samples

Services, contracts and negotiates with primary care, specialty physicians and ancillary providers for all product lines in assigned markets
Manages physician network by developing and maintaining relationships to drive business results within a specific geographic area
Identifies strategies to achieve Medical Expense Initiatives (MEI)
Performs ongoing research to identify new providers or areas of expansion in assigned market
Responds to provider’s contract requests and inquiries
Analyzes network gaps and identifies providers to contract
Reviews and amends provider’s contracts when necessary
Evaluates contracted network to ensure functionality
Assesses performance and contract rates of providers to ensure our network is cost efficient
Researches and develops relationships with non-contracted providers
Collects credentialing and required documents for newly contracted providers
Strategies for membership growth and retention
Handles more complex and higher volume providers
Provides education, training and mentoring to newly hired or less experienced Network Management Representatives
Assists management on special projects and/or initiatives
Performs special projects as assigned
For smaller or emerging markets, the Network Management Representative may perform a dual role with Provider Relation duties. Some associates may perform one or all of the below Provider Relations duties
Completes new provider orientation for all applicable product lines
Conducts site visits to service providers to provides education on policies and initiatives, resolve issues, educate staff/providers on policies, collect credentialing information and review HEDIS information. Addresses RxEffect, P4P, Medical Home, Cultural Competency, FWA, open/closed panels, ADA, PaySpan, ER overuse, et al
Achieves frequency goals to establish consistent and strong relationship with provider offices
Partners with local and national ancillary for appropriate vendor management and coordinates the transition of the delegated providers following a network termination
Provides oversight on claims issues. Follows up with providers accordingly
Monitors and supports providers using utilization reports, pharmacy profiles, ER contingencies, Frequent Flier Reports and other analytics available to improve and maintain regions
Understands and explains fee-for-service and risk contracts, and provides reporting on provider and/or Service Fund performance
Proactively strategies for membership growth and retention, through advanced communication to providers, as well as follow-up to gauge the response to that growth
Partners with Network Development to identify network gaps and suggests additional providers for recruitment to ensure network adequacy
Ensures contract SLA’s are met, such as meeting with PCP’s and Specialists on a monthly, quarterly, or annual basis to address provider panels, after hour’s availability and EMR meaningful use
Required A Bachelor's Degree in a related field
Required 3+ years of experience in Provider Relations, Network Management, Hospital Contracting or related Provider Services position with demonstrated ability to perform the level of duties of the position
Required 3+ years of experience in Managed Care
Required 1+ year of experience in Previous contracting experience
Intermediate Demonstrated written communication skills
Intermediate Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
Intermediate Ability to work independently
Intermediate Ability to work within tight timeframes and meet strict deadlines
Intermediate Demonstrated interpersonal/verbal communication skills
Intermediate Demonstrated customer service skills
Intermediate Ability to represent the company with external constituents
Intermediate Knowledge of healthcare delivery
Intermediate Knowledge of community, state and federal laws and resources

Supervisor Provider Installation Resume Examples & Samples

Work is generally limited to own function
Can discuss upon initial discovery session
5+ years of experience in network management and contracting operational role, including experience with facility / ancillary contract reimbursement methodologies
2+ years’ experience with claims processing systems such as COSMOS, UNET, etc
1+ years’ experience supervisory
Ability to manage multiple projects concurrently, while maintaining a high level of quality and commitment to project timeframes
Ability to multi-task, shifting back and forth effectively between two or more activities or sources of information
Intermediate level of proficiency in Microsoft programs including Excel, Word and Access

Provider Enrollment Supervisor Resume Examples & Samples

Responsible for ensuring timely, accurate enrollment of Company practitioners in health plans
Enters new enrollments in Intellicred and appropriately assigns them to Associates
If a health plan’s enrollment form is inaccurate or out of date, will re-map the form in the Intellicred system
Once enrollment forms are correctly mapped, will notify the Associates to proceed with the application process
Reviews completed applications for accuracy prior to their submission and provides feedback to Associates on any errors
Monitors department reports to ensure enrollments are completed within health plans’ expected time frames
Reviews and tracks returned applications in order to identify and correct errors and identify underlying human or issues that may have contributed to the return
Responsible for ensuring consistent and timely follow-up on outstanding provider enrollments
Monitors reports and audits assignments to ensure standard operating procedures are being consistently followed
Escalates concerns or unresolved issues to appropriate RCM Management
Responsible for ensuring pending and completed provider enrollments are communicated to the affected departments and correctly updated in systems
Monitors e-mailed notifications to the affected departments to ensure timeliness and appropriateness
Attends monthly Provider Enrollment Committee meetings to review open issues, coordinate handling and compare strategies to assure the most efficient resolution
Ensures regional “issues logs” are maintained up-to-date
Ensures effective quality assurance processes are implemented to verify accuracy of Master Database entries and prevent incorrect information from being communicated
Provides ongoing training in Provider Enrollment systems and policies and procedures, and participates in periodic audits to ensure compliance and appropriate training levels
Provides training in Provider Enrollment policies and systems to new Associates and provides corrective training or training in new Provider Enrollment initiatives
Reviews periodic audits of Provider Enrollment policies and procedures and addresses insufficiencies in training or processes with effective corrective action plans
Maintains strict confidentiality in accordance with HIPAA regulations and Company policy
Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment
Any confidential provider information must not be divulged on any assignment except to payers that need the information in order to process enrollment applications
Directs and develops subordinate staff. Interviews and selects subordinate management staff necessary to meet RCM goals and objectives
Oversees and approves the selection of non-management staff in the Corporate Patient Accounts departments
Educates, develops and assists subordinate management personnel to ensure performance and productivity standards are met
Evaluates, recommends and approves actions regarding employee relations matters in accordance with departmental and corporate policies and procedures as necessary
Resolves staff grievances, counsels and authoritatively disciplines department personnel as necessary
Evaluates the performance of subordinate personnel in a timely and effective manner
Holds monthly staff meetings to maintain open communication with the staff
Responsible for “morale-building” activities that are proven by minimal staff turnover
Completes a monthly operations report to the RCM Directors
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties
Performs other job-related duties within the job scope as requested by the Vice President of RCM
Embodies the principles of the corporate Mission Statement and Philosophy at all times
Complies with departmental and company-wide policies and procedures. Completes anual Compliance training requirements
Associate's degree (A. A.) or equivalent from two-year college or technical school; or three or more years related experience and/or training; or equivalent combination of education and experience
Ability to read, analyze, and interpret common and technical journals, financial reports, and legal documents. Ability to respond to common inquiries or complaints from customers, regulatory agencies, or members of the business community. Ability to write speeches and articles for publication that conforms to prescribed style and format. Ability to effectively present information to top management, public groups, and/or boards of directors

Supervisor, Provider Configuration Management Resume Examples & Samples

Responsible for the team achieving or exceeding performance metric targets
Conduct and document operational meetings with health plans, on a weekly basis
Responsible for developing and coaching the team for professional growth

Supervisor of Provider Installation Resume Examples & Samples

Anticipate customer needs and proactively develop solutions to meet them
Serve as a key resource on complex and/or critical issues
Solve complex problems and develop innovative solutions
Perform complex conceptual analyses
Review work performed by others and provide recommendations for improvement
Forecast and plan resource requirements
Authorize deviations from standards
May lead functional or segment teams or projects
Provide explanations and information to others on the most complex issues
Motivate and inspire other team members
5+ years data analysis and/or audit experience within the healthcare industry
4+ years experience in managing cross functional projects and making presentations
4+ years customer response/customer service experience
2 years Demonstrated Program/Project Management Skills, not necessarily formal PM skill
A consulting mentality, engaging, collaborative, an ability to problem solve and develop root cause analysis
Advanced proficiency in MS Excel (pivot tables), Access and PowerPoint

Supervisor, Provider Operations Resume Examples & Samples

Oversees the day-to-day operations of the Provider Operations team
Provides support to field teams in the function of troubleshooting, coordination and administration
Coordinates with management from Network Management, Provider Relations, and other network teams to ensure appropriate prioritization is given to PLFs for network expansion projects
Ensures regularly scheduled meetings with Shared Services teams, such as Configurations and Credentialing, to discuss issues, workload and processes for improved synchronization
Ensures compliance with all regulatory and organizational requirements and standards through process refinement, regular audits, and associate coaching
Partners with local training team to identify and develop applicable training courses for direct reports
Assists is establishing effective departmental practices and works closely with various departments to ensure department and company goals are being met
Performs work flow analysis to monitor consistency and efficiency in processes and procedures
Performs quality audits on a regular basis to ensure PLFs are completed correctly and provider demographic and contractual data is correctly reflected in our systems
Identifies areas to improve service levels within operating budget parameters
Manages resources to meet operational goals and budgets
Assists in implementing corporate initiatives to achieve optimum results
4+ years of experience in a customer service, provider relations and/or network development environment
1+ year experience in leading/supervising others

Supervisor, Provider Operations Resume Examples & Samples

Ensures regularly scheduled meetings with Shared Sevrices teams, such as Configurations and Credentialing, to discuss issues, workload and processes for improved synchronization
Required 4+ years of experience in a customer service, provider relations and/or network development environment
Required 1+ year experience in leading/supervising others
Intermediate Ability to influence internal and external constituents
Intermediate Ability to work in a fast paced environment with changing priorities Ability to work in a fast paced environment with changing priorities
Intermediate Ability to multi-task Ability to multi-task
Intermediate Demonstrated problem solving skills
Intermediate Ability to analyze information and covert related activities into a comprehensive work plan
Intermediate Ability to communicate and make recommendations to upper management
Required Intermediate Microsoft Word Proficient in Microsoft Office such as Word, Excel, PowerPoint and Outlook
Required Intermediate Microsoft Excel Knowledge of project planning software sufficient to document project steps and report progress
Required Intermediate Microsoft PowerPoint

Supervisor of Provider Enrollment Resume Examples & Samples

Directs the assigned department on policy and procedures related to enrollment call center/correspondence/field inquiries
Resolves problems to insure compliance and customer satisfaction
Builds trust and strong business relationships internally & externally
Researches, reports and analyzes call center/correspondence/field data and creates reports for results, monitoring and recommendations
3-5 years of leadership/supervisory experience in managed healthcare
Substantive knowledge of health care policy and direction
Previous experience with enrollment credentialing (strongly preferred)

Supervisor, Provider Services Resume Examples & Samples

Directs the assigned department on policy and procedures related to call center/correspondence/field inquiries
Supervises the team including recruitment, development and motivation of staff
Initiates personnel actions including employment, terminations, performance/salary reviews and disciplinary actions
Facilitates meetings with the teams to discuss issues/suggestions for improvement and assists the manager with the implementation of changes
Works collaboratively with all monitoring functions to assure accuracy and quality of information
4+ years of experience in claims and/or benefits interpretation and provider networking

Supervisor, Provider Operations Resume Examples & Samples

Bachelor's Degree in a related field or equivalent work experience is required
4+ years of experience in a customer service, provider relations and/or network development environment is required
1+ year experience in leading/supervising others is required
Ability to lead/manage others
Demonstrated interpersonal/verbal communication skills
Ability to influence internal and external constituents
Ability to work in a fast paced environment with changing priorities
Ability to multi-task Ability to multi-task
Knowledge of healthcare delivery
Demonstrated organizational skills
Ability to analyze information and covert related activities into a comprehensive work plan
Proficient in Microsoft Office such as MS Word, MS Excel, MS PowerPoint and MS Outlook is required
Knowledge of project planning software sufficient to document project steps and report progress is required

Supervisor / Team Lead, Provider Services Resume Examples & Samples

Associates degree in related field required, including but not limited to Business, Nursing, Health Information Management. Bachelor's degree in related field preferred
Minimum 5 years customer support experience required
Minimum 3 years direct supervision experience required
Previous experience in a call center environment preferred
Ability to work well in and individual and team environment
Computer proficiency in Microsoft Office applications and system databases are required
Requires working knowledge of applicable industry based standards, particularly regarding medical information, medical billing, and private health information

Supervisor of Provider Configuration Management Remote Resume Examples & Samples

Act as liaison with health plans for Provider Information function regarding workflow and submission of required documentation
Appropriately identify issues pertaining to Provider data and document necessary re-work that may be required
3-5 years

Supervisor Provider Services Call Resume Examples & Samples

Coordinates, supervises and is accountable for the daily / weekly / monthly activities of a team members
Sets priorities for the team to ensure task completion and performance goals are met, such as Quality, Adherence, Service Level and AHT
Provides coaching and feedback to team members, including formal corrective action
Provides expertise and customer service support to members, customers, and / or providers
High School Diploma / GED (or higher) OR 10+ years of equivalent working experience in a call center or in a Supervisor / Team Lead roll
Available to work 40 hours per week anytime within the operating hours of the site 8:00 am to 8:00 pm Monday to Friday
3+ years of customer service experience analyzing and solving customer problems
Proficiency with Microsoft Office (Microsoft Word - creating and editing documents. Microsoft Excel - creating, editing spreadsheets, and sorting / filtering. Microsoft Outlook - email, scheduling, and tasks)
Bilingual (Spanish and English)

Supervisor, Provider Configuration Management Resume Examples & Samples

3-5 years experience
Experience managing production team
Experience monitoring performance metrics
Flexibility to support build-out of a new team and process
Strong drive towards building team culture
Ability to communicate cross-functionally on operational processes
Experience with provider data, claims, credentialing, configuration, QNXT and managed care
5-7 years with provider data, claims, credentialing, configuration, QNXT and managed care

Supervisor, Provider Operations Resume Examples & Samples

A Bachelor's Degree in a related field required
4+ years of experience in a customer service, provider relations and/or network development environment required
1+ year experience in leading/supervising others required
Intermediate - Ability to lead/manage others
Intermediate - Demonstrated interpersonal/verbal communication skills
Intermediate - Demonstrated written communication skills
Intermediate - Ability to influence internal and external constituents
Intermediate - Ability to work as part of a team
Intermediate - Ability to work in a fast paced environment with changing priorities
Intermediate - Ability to multi-task
Intermediate - Knowledge of healthcare delivery
Intermediate - Demonstrated organizational skills
Intermediate - Demonstrated problem solving skills
Intermediate - Ability to analyze information and covert related activities into a comprehensive work plan
Intermediate - Ability to communicate and make recommendations to upper management
Intermediate proficiency in Microsoft Outlook, Word, Excel, and PowerPoint

Supervisor, Provider Services Resume Examples & Samples

Maintain an up-to-date and working knowledge of THP database systems, policies and procedures, benefits, claims, enrollment programs, and state and federal mandates
Provide on-the-spot technical and behavioral support to all front-line staff
Assist in new hire and ongoing training programs. Ensure staff is knowledgeable of THP policies, products, benefits and procedures through active coaching and educational training
Function as an internal consultant to staff in answering and resolving complex issues

Supervisor Provider Check Unit Resume Examples & Samples

Associate’s Degree
Bachelor’s Degree - preferred
Minimum of three (3) years experience in a leadership position
Minimum of three (3) years experience in a Medicaid Claims or HMO environment
Minimum of three (3) years Facets experience, preferably in more than one line of business
Minimum of two (2) years experience preparing, analyzing and trending data
Minimum of 5 years progressively responsible Claims, TPL, and/or Cost Containment background
Technical experience must consist of Microsoft Excel & Access, EXP, and Facets