Provider Data Management Specialist

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

One Community. One Mission. One California

***This position is remote but will be expected to work PST business hours.

Position Summary:

The Clinical Integration (CI) and Accountable Care Organization (ACO) programs are clinically integrated physician networks sponsored by Dignity Health (DH). In order to fill service gaps in a CI/ACO Network a complementary network of ancillary providers is maintained in each region. The Provider Data Management Specialist is an employee of Dignity Health Management Service.

Under the direction of the Manager this individual:
- provides data management support services to Dignity Healths CI/ACO Networks Employer Relations and Valued Based Operations (VBO)
- within the Salesforce platform this individual gathers and maintains accurate provider data performs periodic provider data reconciliations with multiple data sources including 3rd party payors
- generates reporting on the provider network
- conducts review of network adequacy and capabilities
- maintains and transmits fee schedules as necessary to third-party administrators (TPAs) and other appropriate stakeholders
- provides customer support services to Dignity Health CI/ACO Networks and VBOs team.

The Provider Data Management Specialist also supports network development to ensure the integrity accuracy and completeness of provider information across internal systems enabling efficient operations compliance and network performance. This role is foundational to the success of network optimization efforts in each of the national Value-Hub markets.

Minimum Qualifications:

- Minimum 3 years experience in provider relations provider credentialing provider database maintenance and reporting provider contracting and/or network development in a health care or managed care setting
- HS diploma or GED
- Demonstrated skills in the areas of written and verbal communication judgment and problem-solving.
- Strong proficiency in Microsoft Office products required.
- This position requires a highly motivated person with exceptional customer service relationship management and interpersonal skills.
- Attention to detail.
- Capable of independent thinking as well as perform in a team environment.

Preferred Qualfications:

- Bachelors degree in Business Finance Health Care Management Economics preferred