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Provider Data Management Specialist I

Plainfield, Indiana Apply Now Job ID 1130490 Category Network Development & Contracting Organization Managed Health Services IN Schedule Full-time
Description:
Position Purpose: Maintain accurate databases and reports to monitor network compliance with State requirements

  • Create and maintain multiple databases, including, contract provider network, prior authorization, third party liability, provider set ups and related corrections
  • Oversee the provider termination process including adding and changing new or existing provider records in the medical information system
  • Schedule monthly provider verifications regarding provider enrollment specifications and demographic changes
  • Update delegated provider Medicare and Medicaid documents on a monthly and ad hoc basis and ensure state compliance
  • Provide appropriate reports and statistical data to other department designees for review, follow-up and resolution
  • Perform general administrative tasks in support of assigned department
  • Qualifications:

    Education/Experience: High school diploma or equivalent. 2+ years of provider data or network administration experience, preferably in a managed care setting. Proficient in Microsoft Office applications, preferably Access and Excel. Previous experience with database management, reporting and analysis preferred. Associate’s degree in health care or a related field preferred.

    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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    • Network Development & Contracting, Plainfield, Indiana, United StatesRemove

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