Imagine Health
  • Cottonwood Heights, UT, USA
  • Full Time

Summary

The Provider Data Management Specialist is responsible for installation and ongoing maintenance of contracted provider data. This directly impacts the experience of the members, providers, and third-party administrators that access contracted providers and utilize provider look-up data.

Duties and Responsibilities

  • Set up and load systems with new provider demographic information once contract is executed with the provider.
  • Ensure the data loads meet quality standards. Participate in testing and audit activities related to data integrity and accuracy.
  • Monitor and update data based on revised rosters received from health systems and other contracted providers in a timely manner.
  • Ensure organized storage of all relevant provider documents.
  • Investigates and resolves provider file inaccuracies and discrepancies, coordinating with other departments as necessary.
  • Interact with provider offices to verify updates to provider information.
  • Assist with provider education efforts on contracted status inquiries.
  • Support provider contracting department with issue resolution and data needs as appropriate.
  • Coordinate with Credentialing department to identify and update provider data based on provider credentialing efforts.
  • Understanding department, segment, and organizational strategy and operating objectives, including their linkages to related areas. 
  • Provide feedback on system limitations or expansion needs as a user of provider management database. Participate in any testing and validation of system changes and improvements.
  • Other duties as assigned.

Education and Experience

  • Associate's degree or relevant experience
  • Previous health insurance / network experience preferred
  • Previous provider data loading and maintenance experience

Specialized Skills/Knowledge

  • Proficient in the MS Office Suite to include MS Word, Excel and Outlook
  • Excellent organizational, interpersonal, presentation, facilitation, and communication skills
  • Demonstrated commitment to high professional ethical standards
  • Ability to adapt to a fast paced, continually changing business and work environment while managing multiple priorities
  • Excellent follow-through skills, self-motivated and detail-oriented
  • Strong organizational skills to manage multiple projects, issues, and priorities effectively and simultaneously, with attention to detail

 

Imagine Health
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