Submission for the position: Provider Data Management Specialist II - (Job Number: 1294317)
https://centene.taleo.net/careersection/jobdetail.ftl?job=1294317&lang=en
Provider Data Management Specialist II
You could be the one who changes everything for our 25 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, multi-national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Maintain accurate databases and reports to monitor network compliance with State requirements. Review and audit provider set ups within business systems to ensure compliance.
• Maintain and update provider data applications and coordinate the data verification process for providers enrolled in networks
• Oversee and coordinate operational and administrative activities associated with provider relations, including provider education and liaison responsibilities, marketing and promotion, and facilitation of credentialing and certification
• Manage and resolve complex provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests
• Coordinate provider data between the health plan database and various external vendors and internal business systems
• Participate in the reconciliation and provider data projects
• Oversee the provider termination process including adding and changing new or existing provider records in the medical information system
• Design and generate reports to monitor department activity, current panel providers and State compliance
Education/Experience:
High school diploma or equivalent. 3 years of provider data or network administration experience, preferably in managed care. Proficient in Microsoft Office applications, preferably Access and Excel. Database management, reporting, auditing and analysis preferred. Associate’s degree in healthcare or a related field preferred.
Our Comprehensive Benefits Package:
Flexible work solutions including remote options, hybrid work schedules and dress flexibility
Competitive pay
Paid Time Off including paid holidays
Health insurance coverage for you and dependents
401(k) and stock purchase plans
Tuition reimbursement and best-in-class training and development
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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