Provider Data Management Specialist (Healthcare)

Overall Purpose :

The Provider Data Management Specialist is responsible for overseeing the accuracy integrity and maintenance of provider data within P3 internal systems. The Provider Data Management Specialist ensures data integrity across systems to support claims processing provider directories regulatory compliance and operational efficiency. This role acts as a liaison between internal contracting health plans and credentialing to ensure successful maintenance of data through all stages of provider enrollment.

Essential Functions

• Supports contracting and credentialing with obtaining accurate provider data. Responsible for building positive relationships between the health plan providers and practice managers.
• Manage processes for provider data integration and system enhancements working with systems to develop reporting. This includes supporting the development and publication of provider directories for various internal stakeholders. Serve as the primary point of contact for provider data-related inquiries and issue resolution. Maintains audits and updates notice of change documentation for all providers.
• Identifying gaps in network composition and services to assist the department.
• Identifying operational short-falls researching and remediating issues.
• Handles confidential and non-routine information.
• Delivers assigned projects on time and compliant to applicable state and federal regulations.â Organizes and prioritizes large volumes of information.
• General administrative duties.

Knowledge Skills and Abilities

Experience

Education

Required Experience :

IC

Key Skills

GIS,Computer Data Entry,Facilities Management,ADMA,Fleet,Key Account

Employment Type : Full-Time

Experience : years

Vacancy : 1