Your career starts now. We’re looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we’re passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we’d like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. **About this job:** The Medicare Performance Data Integrity Manager will report to the Director of Medicare Performance Management and will lead a team with a focus on managing the operational performance of Medicare Data Integrity and regulatory report production. The Manager is responsible for developing and maintaining the operational oversight of the Performance Management team under their direct scope of responsibility while partnering with compliance, senior leadership, and departmental business owners to develop and operationalize data aggregation/reporting by contractual and regulatory requirements.; **Responsibilities:** + Responsible for strategy, implementation, day-to-day operations, and supervising the Medicare Data Integrity team, including management of the Medicare Data Request process and accurate, timely production of regulatory and operation oversight reports. + Responsible for maintaining subject matter expertise in operational, reporting, and regulatory requirements for all Medicare lines of business. + Leadership and direction of a team of Specialists, Analysts, or Project Managers who are developing and implementing business review documents, reports, and data visualization development and analysis. + Providing senior leadership with analytical performance metrics on all task performance requirements. + Taking proactive preventative steps to resolve issues and manage risk. + Partners with the business area leaders to coordinate reviews and prepare for annual oversight and regulatory audits, examining monitoring findings and responding to cited deficiencies. + Making recommendations for corrective actions and monitoring remediation and corrective action plans. + Manage staff, including, but not limited to, recruiting, selecting, orienting, and training new staff; monitoring staff's day-to-day activities; monitoring staff performance; mentoring, training, and cross-training; handling questions or issues raised by staff; and encouraging staff to provide recommendations for relevant process and systems enhancements, among other things. + Adheres to AmeriHealth Caritas policies and procedures. + Creates and supports an environment that fosters teamwork, cooperation, respect, and diversity. + Instills a work culture of continuous process improvement, innovation, and quality. + Demonstrates and supports commitment to corporate goals and objectives. + Performs other related duties and projects as assigned. ; **Education & Qualifications:** + 3 to 5 years of working knowledge of SQL database and tools, e.g., TOAD, SQL developer preferred. + Bachelor’s degree in business, management information systems, or 5 years of equivalent work experience. + Experience in contract and/or Medicare regulatory requirements analysis in Dual-Special Needs or Medicare-Medicaid Plans. + Supervisory/management experience. + Demonstration of both qualitative and quantitative analytical skills. + Proven ability to work with diverse people, including physicians, support staff, coworkers, and management. + Demonstrated ability to research issues and bring about resolution either directly or with the assistance of others. + Demonstrated critical thinking and problem-solving skills. + Strong written and verbal communication skills. + Strong elicitation and process documentation skills. + Strong organizational and communication skills to build and foster effective relationships. + Working knowledge of Microsoft Office Suite and Tableau. + Ability to travel up to 25% of the time, as needed. ; **Diversity, Equity, and Inclusion** At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. We keep our associates happy so they can focus on keeping our members healthy. **Our Comprehensive Benefits Package** Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, including holidays and volunteer events, health insurance coverage for you and your dependents on day one, 401(k) tuition reimbursement, and more. ; As a company, we support internal diversity through: Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.