Manager, Data Operations

Our partner is currently seeking a remote Manager, Data Operations based in Chicago, IL. The role involves overseeing the implementation, integration, management, and delivery of data interchange with Pharmacy Benefit Managers (PBMs). The position encompasses daily operations, maintenance of PBM-related processes, and ensuring robust quality standards.

Responsibilities:

• Manage day-to-day operations and inquiries related to RxClaims data.
• Review, prioritize, and assist with reported discrepancies in claims data, accumulators, and member complaints.
• Establish SLAs for issue resolution and transparency in the process.
• Establish and maintain relationships with PBMs connected with.
• Oversee the daily processing of all inbound and outbound data processing.
• Manage Data Analysts.
• Demonstrate a strong understanding of internal business needs and technical requirements.
• Develop and implement new data management audits and quality assurance protocols.
• Project manage PBM projects to completion.
• Establish data connections with trading partners.
• Interface with the IT team on projects and data management strategies.
• Ensure all PBM file changes are executed correctly and timely.
• Build collaborative, cross-functional teams and trusted business relationships.
• Act as an internal and external point of contact for data management issues.
• Act as a liaison between the internal team and external trading partners.
• Act as an escalated point of contact for data management issues.
• Lead, coach, motivate, and develop teams, conducting one-on-one meetings, performance appraisals, and growth opportunities.
• Clearly communicate expectations, provide training, resources, and information needed for success.
• Actively engage, coach, counsel, and provide timely, constructive performance feedback.
• Work on special projects, duties, or tasks as assigned.

Physical Demands:

• This is an office environment requiring extended sitting and computer work.

Work Environment:

• Remote.

Requirements

• Bachelor's degree or equivalent work experience required.
• Project Management Professional (PMP) certification desired.
• Minimum of 5 years of experience in a similar role, preferably data operations in healthcare and/or insurance.
• At least 3 years at a supervisor level with demonstrated leadership competencies.
• Previous project management experience.
• Required experience with SQL and Microsoft Power BI.
• Working knowledge of data management, data warehousing, and coding languages.
• Excellent knowledge of data integration programs within the healthcare environment.
• Strong work ethic, positive attitude, and exceptional ability to manage multiple projects in a fast-paced environment.
• Strong communication skills (both verbal and written) and the ability to provide recommendations on data integrations and applications.
• Strategic, conceptual analytical thinking, and decision-making skills.
• Ability to advise on complex technical matters to all stakeholders; ability to communicate effectively with senior management.