Provider Supervisor Job Description
Provider supervisor
provides education on policies and initiatives, resolve issues, educate staff/providers on policies, collect credentialing information and review HEDIS information.
Provider Supervisor Duties & Responsibilities
To write an effective provider supervisor job description, begin by listing detailed duties, responsibilities and expectations. We have included provider supervisor job description templates that you can modify and use.
Sample responsibilities for this position include:
Monitors operational policies and procedures, including setting goals, standards and benchmarks to evaluate staff performance employee and customer satisfaction
Drive team level accountability to support improved quality results, assure audit results are properly documented and monitor appeal overturn rate by driving reduction of auditor error
Provide regular coaching and feedback to team members, including formal corrective action when needed completing annual performance reviews
Supervise daily activities of the provider data management team within the Physical Health network area
Coordinates work activities with other supervisors, managers, departments
Coordinates work activities with other supervisors, managers, departments, Identifies and resolves operational problems using defined processes, expertise and judgment
Conducts outbound contact activity
Completes Provider Contract Surveys
Prepares, verifies and maintains provider demographic information and panel status reports
Performs staff training regarding TRICARE benefits policy and procedure changes
Provider Supervisor Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Provider Supervisor
List any licenses or certifications required by the position: BLS, CPR, BSL, ACLS
Education for Provider Supervisor
Typically a job would require a certain level of education.
Employers hiring for the provider supervisor job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Education, Management, Business, Medical, Health Care, Physician Assistant, Healthcare, Health Information Technology, Associates, Communications
Skills for Provider Supervisor
Desired skills for provider supervisor include:
Continuing staff education and professional development
Diagnosis
Document staff issues and performance
Documentation
Employee supervision
Ethics issues
Evaluate
Human resources management policies
Monitor
Outcomes measurement
Desired experience for provider supervisor includes:
Knowledge of the Massachusetts provider community preferred
1+ year of experience as a Supervisor managing a team of 5 or more people
Supervises daily call center staff, adhering to policies and procedures, including meeting call center operational standards
Manages departmental workflow procedures and service levels
Develops and mentors staff
Basic knowledge of ACA plans (operations manual, systems manual, contract)
Provider Supervisor Examples
1
Provider Supervisor Job Description
Job Description Example
Our growing company is hiring for a provider supervisor. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for provider supervisor
- Monitor staff performance, recognize achievements, and follow up on areas of deficiency
- Educates PEC specialists on updates and system changes to ensure synchronized process of data and documentation to meet regulatory guidelines and standards
- Evaluating employee assets (computer, headsets, chairs, ) for availability, functionality and effectiveness
- Advises on the development of critical corporate guidelines and best practices working closely with credentialing processing centers
- Identify and communicate all concerns regarding enrollment and credentialing, including barriers that prevent timely completion
- Assist in preparation for state and federal audits, responding to auditor’s inquiries and preparing responses to findings working closely with the lead coordinator
- Conduct quarterly, semi-annual, and annual credentialing reviews and prepare reports for Director of AR and governance meeting
- Establish high performance goals that are measurable and hold team accountable
- Bring together joint initiatives around internal/external departmental boundaries and facilitate shared ideas to ensure successful outcomes
- Manage multiple projects under tight deadlines
Qualifications for provider supervisor
- Database management, design, and quality improvement experience is also desired
- Works closely with revenue cycle leadership to ensure excellence in enrollment/credentialing activities
- High School Diploma or higher level education
- 3 year management experience leading credentialing and enrollment in managed care, work comp, and governmental plans for multiple states required, including Medicare and Medicaid required
- 3 year revenue cycle experience required
- Current Certified Provider Credentialing Specialist (CPCS) preferred
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Provider Supervisor Job Description
Job Description Example
Our company is searching for experienced candidates for the position of provider supervisor. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for provider supervisor
- Ensure all employees within the assigned team(s) understand and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations
- Supervises/directs daily operations of subordinates to complete assignments using established guidelines, procedures and policies (to include management of staff attendance, time cards, time off requests, dress code policy )
- Develop innovative strategies and initiatives to maximize staff productivity and reduce/eliminate waste
- Decisions have direct impact on work unit operations
- Supervises and develops provider outreach staff
- Hires/motivates, and evaluates a diverse group of professionals to assure the effectiveness of Provider Quality programs
- Contributes to the development and execution of multiple provider campaigns focused on improving clinically oriented HEDIS and HOS scores customer satisfaction oriented CAHPS survey results
- Possesses a deep understanding of the Medicare STARS program and assists with the implementation and execution of strategy related to the quality incentive program
- Assists with the execution of provider pay for performance programs aimed at aligning goals to achieve high quality care
- Collaborates with providers on the development of initiatives to drive member engagement for the closure of gaps in care
Qualifications for provider supervisor
- Knowledge of urgent care and billing/credentialing preferred
- Knowledge of provider/entity enrollment and credentialing requirements
- Knowledge and understanding of AMA, AOA, NPPES, DEA, DPS, NPDB, SAM, EPLS, OIG, and AAAHC
- Ability to analyze and interpret a wide range of information
- Ability to manage multiple projects effectively while facilitating group success
- Must be able to present formal communications on a weekly, monthly quarterly, yearly basis in spreadsheet/graph format to Director/Urgent Care Leadership regarding updates, status, data analysis, audit findings, timelines, and other pertinent information for planning, accountability, and growth purposes
3
Provider Supervisor Job Description
Job Description Example
Our growing company is looking for a provider supervisor. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for provider supervisor
- Monitors and maintains staff productivity and acts as a key resource to internal quality improvement areas and constituents
- Provides and coordinates staff training for maximum performance and provides developmental opportunities
- Responsible for communication to staff of established policies, procedure and changes as they occur
- Encourages collaboration and mentors other staff members and serves as team leader
- Contribute to the development of annual department strategic planning and goals
- Assists in ongoing training initiatives for all Team Members
- Functions as technical expert for their team
- Prepare employee performance reviews
- Record and maintain statistics for staff and the department
- Work in conjunction with other management to allocate and adjust team resources as daily needs require
Qualifications for provider supervisor
- Strong written, phone, and verbal communication skills, proven ability to communicate with physicians, APPs, and leadership
- Perform annual evaluations for direct reports with development goals and coaching as needed
- Ability to interview, hire, and fire
- Stay abreast of industry changes in healthcare, including enrollment and credentialing
- Knowledge of and adherence of HIPAA regulations and guidelines
- 2+ years’ experience with claims processing systems such as COSMOS, UNET
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Provider Supervisor Job Description
Job Description Example
Our company is growing rapidly and is looking for a provider supervisor. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for provider supervisor
- Assess and approve time off requests
- Assist in new hire and ongoing training programs
- Provide guidance to staff on questions and issues and manage escalated situations
- Responsible for assigning day-to-day application and updates tasks
- Researches and responds to any escalated provider inquiries and requests in a timely, professional and informative manner
- Applies feedback to staff members to improve performance
- Effectively leads coaches, trains and counsels team members
- Works closely with Quality Assurance (QA), and PEC Management to ensure all applications and updates are process according to established service level agreements (SLAs)
- Monitors employee performance for compliance to established performance expectations
- Manages the daily operations of assigned team comprised of approximately 15-25 employees
Qualifications for provider supervisor
- Provide leadership and development for the team
- Lead and participate in team meetings
- 3+ years working with provider data/provider contracts/contract installation
- Intermediate proficiency in MS Office, including MS Excel and PowerPoint
- Required to have a dedicated work area established that is separated from other living areas
- Required to have a work area in a section of the residence that provides information privacy
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Provider Supervisor Job Description
Job Description Example
Our growing company is looking for a provider supervisor. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for provider supervisor
- Communicates clear expectations for performance and attendance, and hold agents accountable for delivering on what’s expected
- Identify provider trends and communicate proposed changes or department needs
- Administers HR initiatives including hiring and onboarding, training, compensation planning, performance management, employee relations concerns/issues and employee development – engaging Sr
- Administers performance management steps and disciplinary action on a timely basis, consistent with company policy
- Regularly monitors morale and assesses necessary actions
- Serves as a liaison between key matrix partners and PSU to ensure continuous quality improvement in work processes associated with the “HCP Experience”
- Handles escalated calls with providers, identifying the root cause of issues and coordinates resolution
- Prepares trending reports
- Manages and promotes provider satisfaction through ensuring proactive service, support, and education both internally and externally
- Knowledge source for the Provider Relations Staff
Qualifications for provider supervisor
- Develops an effective system for processing and distributing payments in a timely manner
- Ensures the efficiency, timeliness and the accurate processing of company invoices, check requests and expense reports the timely generation of payments
- Oversees the day to day functions of the payables, assists with supervising staff within the department and develops and provides training on new procedures and ensures team resources are used efficiently
- Ensures that all user guides, policies and procedures are current and in compliance
- Leads and oversees the processing and distribution of 1099 and the timely reporting of the tax information to the state agency
- Minimum of 5 years recent and related experience in provider networking, with a focus on continuous quality improvement with an understanding of how to drive business results