Provider Data Management Specialist

Summary

Imagine360 is a company focused on healthcare operations, and they are seeking a Provider Data Management Specialist. This role is responsible for the installation and ongoing maintenance of contracted provider data, ensuring data integrity and supporting various departments with provider-related information.

Responsibilities

• Set up and load systems with new provider demographic information once contract is executed with the provider
• Experience using SQL and data analytic tools for reporting and data analysis
• 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

Skills

• Associate Degree or relevant experience
• Previous provider data loading and maintenance
• 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
• Previous health insurance/network experience

Qualifications

Must Haves

• Associate Degree or relevant experience
• Previous provider data loading and maintenance
• 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

Nice to Haves

• Previous health insurance/network experience