Coordinator, Provider Data

Socket.dev; Boston (MA); Hybrid; USD 52,000 - 72,000; Full time

Job summary

Community Care Cooperative (C3) in Boston, MA is seeking a Provider Data Coordinator to manage provider records across databases, ensure accuracy, timely updates, and compliance with regulatory and network requirements. The role supports affiliation activities and data submissions from our FQHC network.

You will organize files, load data, reconcile discrepancies, generate routine reports, and collaborate with credentialing teams and external entities to maintain data integrity in a fast-paced

Qualifications

• Health industry and network data experience required.
• Familiarity with credentialing requirements.
• Experience with data processing, reporting and data quality.

Responsibilities

• Organizes files, loads database and updates online systems with new provider information from our network.
• Ensures data loads meet quality standards and participates in reconciliation and audits.
• Resolves provider file discrepancies and coordinates with departments, FQHCs and regulatory bodies.
• Provides input on updating internal processes that support provider data management.
• Supports development, maintenance and implementation of policies for provider data management.
• Assists with provider training, documentation and template development.
• Coordinates with credentialing departments to identify and update provider data.
• Maintains relationships with internal and external entities and develops reports as needed.
• Participates in reporting and system validation to improve data quality.

Skills

Healthcare industry

Attention to detail

Multitasking

Problem solving

Time management

Independent worker

Initiative

Communication skills

Education

Associate degree or equivalent

High School Diploma

Job description

Location: Boston (Hybrid)

Organization Summary:

Community Care Cooperative (C3) is a 501(c)(3) non-profit multi-service organization governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We fulfill two primary business functions for the FQHCs we work with. First, we are an FQHC-led accountable care organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs.

As an ACO, we negotiate value-based payor contracts on behalf of our FQHCs, hold and operate those contracts (including fulfilling many compliance, financial management, and population health management functions), and maximize the return to FQHCs of any incentive dollars earned. We are proud to be the market leader in the MassHealth ACO Program. We are the largest Medicaid ACO in Massachusetts, and we operate a variety of business offerings nationwide.

As an MSO, we (along with our subsidiary companies, which are also FQHC-led non-profits) provide several financial, operational, and technological services to groups of FQHCs. These services include Epic EHR licensing and implementation; pharmacy operations consulting as well as the building and direct operation of on-site retail pharmacies; billing and credentialing; employer-sponsored insurance; and others.

We are a fast-growing, dynamic organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.

Job Summary:

The Provider Data Coordinator is responsible for data processing, reporting, and ongoing maintenance of network provider data in database and online systems as well as supporting affiliation activities within the network as necessary and applicable. This individual ensures adequate engagement with participating FQHCs and Affiliated Participating Providers and timely data management and submission of necessary paperwork to regulatory, contractual and network entities. The Coordinator is responsible for provider data accuracy, reconciliation activities, reporting, and compliance.

Responsibilities:

• Organizes files, loads database and updates online systems with new provider information based on provider rosters and applications received from our network of FQHCs and providers
• Ensures that the data loads meet quality standards and participates in reconciliation and audit activities related to data integrity and accuracy
• Investigates and resolves provider file discrepancies, and coordinates activities with other departments, FQHCs, affiliated providers, and regulatory agencies entities as necessary
• Provides an input on updating internal processes that support the provider data management activities
• Supports development, maintenance, and implementation of policies and procedures that support organizational processes related to provider data management
• Assists with provider training, documentation, and template development and provides based on internal processes and regulatory requirements
• Coordinates with credentialing departments within our network to identify and update provider data based on provider credentialing efforts
• Works closely with multiple internal and external entities to maintain a good relationship
• Develops reports for the organization and external entities as necessary
• Participates in reporting and system validation to ensure improvements and quality of data and reporting
• Performs other tasks, duties, or projects as assigned

Required Skills:

• Health industry and network experience required
• Meticulous orientation to details
• Ability to prioritize, handle multiple concurrent assignments in an organized manner and to adapt to fluctuating situations
• Excellent problem solving, organization, and communication skills
• Time management skills with the ability to meet deadlines
• Ability to work independently with limited supervision and to collaborate as necessary
• Ability to take initiative and be efficient
• Must be able to remain in a stationary position 50-75% of the time

Desired Other Skills

• Familiarity with credentialing requirements
• Provider data management preferred
• Familiarity with the MassHealth and Medicare ACO program
• Familiarity with Federally Qualified Health Centers
• Experience with anti-racism activities, and/or lived experience with racism is highly preferred

Qualifications:

• Associate degree or High School Diploma with at least three years of relevant experience

** In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **