Network Operations Sr. Manager - Evernorth - Remote

📋 Description

• • Lead the day-to-day execution and performance of critical network operations, specifically focusing on onshore provider maintenance and offshore provider data management.
• • Own the operational strategy, including comprehensive capacity planning and rigorous performance oversight, ensuring all defined service level agreements (SLAs), quality standards, and compliance expectations are consistently met and exceeded.
• • Drive operational excellence by collaborating closely with matrix partners and global service partners (GSPs) to effectively manage inventory, optimize staffing models, and ensure equitable workload distribution across both onshore and offshore teams.
• • Foster a data-driven decision-making environment to ensure appropriate resourcing, maintain operational readiness, and champion continuous performance improvement initiatives that directly support network accuracy, enhance the provider experience, and positively impact downstream business outcomes.
• • Oversee and manage the performance of direct reports, including managers leading onshore provider maintenance and offshore provider data management teams, ensuring the accurate, timely, and efficient processing of all provider adds, terms, and updates.
• • Conduct regular reviews of key operational metrics, including service levels, productivity, and quality, to identify performance trends and proactively develop and execute targeted action plans to address any performance gaps and sustain high levels of achievement.
• • Maintain accountability for meeting and exceeding defined performance, accuracy, turnaround time, and compliance expectations across all assigned provider data portfolios, ensuring the integrity and reliability of network information.
• • Lead strategic analysis of operational data and reporting to uncover critical trends, identify potential risks, and pinpoint opportunities for enhancement, translating complex data into clear, actionable insights.
• • Proactively recommend and champion enhancements to existing tools, workflows, and processes to drive significant improvements in operational efficiency, enhance scalability, and elevate overall data quality.
• • Identify, prioritize, and lead the implementation of mid- to large-scale operational improvement initiatives that have a tangible impact on provider data accuracy and the overall integrity of the network.
• • Address performance and quality findings at all levels – team, cross-team, and organizational – acting as a key change leader to identify and remove systemic barriers that hinder progress and optimal performance.
• • Engage actively and communicate effectively with a diverse range of matrix partners, including resource management, capacity planning, technology teams, and various business stakeholders, to collaboratively develop and execute strategies that enhance performance and resolve operational challenges.
• • Manage and nurture relationships with global service partners (GSPs), ensuring clear alignment on expectations, effective staffing models, desired performance outcomes, and collaborative continuous improvement initiatives.
• • Cultivate and sustain a positive, inclusive, and high-performing team culture through transparent communication, active engagement, and dedicated development of both managers and individual contributors.
• • Provide essential mentoring and coaching to people leaders, empowering them to successfully achieve their goals and further develop their leadership capabilities.
• • Demonstrate managerial courage by directly addressing performance issues and consistently delivering accurate, transparent, and timely messaging to all staff, fostering an environment of trust and accountability.
• • Ensure strict adherence to all applicable state and federal regulations, internal policies, and audit requirements related to provider data management and network operations.
• • Partner effectively with compliance and audit teams to facilitate reviews, support issue remediation efforts, and contribute to ongoing risk management activities.
• • Communicate operational performance, identified risks, and ongoing improvement initiatives effectively, both verbally and in writing, to senior leadership.
• • Ensure the consistent and clear dissemination of information, priorities, and expectations to all teams and relevant stakeholders, maintaining alignment and focus across the organization.