Provider Data Integrity Lead

UnitedHealth Group; United States; Remote; USD 33,000 - 50,000; Full time

Job summary

The Cigna Group is seeking a Provider Data Lead Representative to ensure accurate maintenance and integrity of provider data across core systems including HCPM, CPF, and Facets. You will resolve fallout from claims, demographics, and contracts to enhance customer and provider experiences.

Responsibilities include data additions, terminations, and updates, data remediation, and applying contract terms. Collaboration within a team and adherence to quality standards are essential.

Qualifications

• High school diploma or GED is required; some college coursework preferred.

Responsibilities

• Execute provider data additions, terminations, and updates per procedures.
• Perform data remediation in HCPM, CPF, and Facets to maintain accuracy.
• Implement updates from quality audits to improve integrity.
• Apply contract terms and network rules for accurate data outcomes.
• Identify operational risks during data load and take corrective action.
• Validate data accuracy across systems and ensure transmission to downstream platforms.
• Conduct root cause analysis to diagnose issues and implement solutions.
• Analyze intake requests to assess impact and perform provider/network updates across systems.
• Adhere to production and quality standards, documenting in the Daily Activity Log (DAL).
• Support testing, validation, and checkout activities for system enhancements.
• Collaborate effectively within a team while maintaining accountability for results.

Skills

Data flow understanding

Contracts knowledge

System downstream impacts

Root cause analysis

Cross-system data validation

Education

High school diploma or GED

Some college coursework

Tools

CPF

HCPM

Proclaim

Facets

DAL

Inventory Manager

ETQS

Activity Manager

Provider Manager

Renaissance

Knowledge Exchange

Job description

The Cigna Group is seeking a Provider Data Lead Representative to ensure accurate maintenance and integrity of provider data across core systems including HCPM, CPF, and Facets. You will resolve fallout from claims, demographics, and contracts to enhance customer and provider experiences.

Responsibilities include data additions, terminations, and updates, data remediation, and applying contract terms. Collaboration within a team and adherence to quality standards are essential.