Provider Data Manager Coordinator

CXCENTRODECONTACTO; Claussville (PA); On-site; USD 42,000 - 65,000; Full time

Job summary

One Call is seeking a Provider Data Management Coordinator to load, update, and maintain network provider data across systems. You will perform data analysis, cleanse data, and support new data pipelines to ensure data accuracy and integrity across the enterprise.

You will collaborate with Providers, Provider Network, and various One Call teams, handling missing information, data entry requests, and ongoing data maintenance while ensuring compliance with internal policies and regulatory

Qualifications

• High School diploma required. Associate degree preferred.
• 2+ years general data management, healthcare setting or provider data management preferred.
• Experience with data analytics.
• General knowledge of US healthcare system and workers' compensation industry preferred.
• Proficiency with computer systems and MS Office applications (Outlook, Word, Excel, PowerPoint, PDF editors).
• Combination of education and experience will be considered.

Responsibilities

• Provide operational support and perform data maintenance and clean-up for data transactions (basic to complex).
• Handle outreach with providers or submitters for missing information to complete data entry requests.
• Respond to inquiries and issues related to provider data requests from providers and One Call staff; escalate as needed.
• Assist with special projects to ensure provider data integrity.
• Validate system enhancements as needed.
• Enter, update, and load provider data into One Call systems per policies and network contracts.
• Deactivate providers per policy and protocol.
• Maintain accurate databases for regulatory reporting and auditing.

Skills

Data management

Data analytics

Communication

Time management

Team collaboration

Education

High School diploma

Associate degree

Tools

Microsoft Excel

Outlook

Word

PowerPoint

PDF editing tools

Job description

JOB SUMMARY:

The Provider Data Management Coordinator is responsible for the initial, updated loading, and maintenance of network provider demographic, credentialing, and contracting information into the appropriate One Call systems within the assigned product line. You will perform technical and data analysis and support the enablement of new data pipelines to move, transform, cleanse, and populate data into downstream systems and interfaces. This position works collaboratively with Providers, Provider Network, and all areas within One Call to ensure provider data is current and accurate. Duties include identifying, researching, and resolving inconsistent data, and maintaining provider data integrity throughout the One Call Enterprise.

DUTIES & RESPONSIBILITIES:

GENERAL DUTIES: 25 %

• Provides operational support, performs data maintenance and clean-up for data transactions (basic to complex).
• Outreach in response and follow-up with the provider or submitter on missing information to complete data entry request.
• Responds to inquiries and issues related to requests coming directly from providers and other One Call staff. If necessary, appropriate, and timely referral of issues to Provider Network or other One Call staff.
• Facilitates or assists with special projects and other initiatives to ensure provider data integrity through complete and accurate entries.
• Performs validation of system enhancements, as needed.

PROVIDER DATA MANAGEMENT: 50%

• Accurate and timely entry, pricing loads, maintenance, and updates of provider data into the One Call systems based upon established policies and protocols and Network contract requirements.
• Deactivate/Terminate providers per One Call policy and protocol.
• Research, review, confirm, and make updates within the One Call systems, per provider request.

CONTRIBUTE RESPONSIBLY 25%

• Maintain accurate databases for reporting to monitor network compliance with regulatory requirements.
• Maintain compliance with data integrity and timeliness polices and protocols.
• Participate in the reconciliation, provider data projects, and auditing of provider data within business systems to ensure compliance.
• Ensure compliance with policies by rejecting any request for data entry or loads that is not permitted based on these policies.

EDUCATIONAL AND EXPERIENCE REQUIREMENTS:

• High School diploma required. Associate degree preferred.
• 2 + years general data management, with preferred experience in a healthcare setting or in provider data management.
• Experience with data analytics.
• General knowledge of the U S Healthcare system and workers compensation industry preferred.
• Proficiency with computer systems required, including web-based applications and Microsoft Office applications which include Outlook, Word, Excel, PowerPoint, PDF editing programs, and various other applications.
• Any combination of academic education, professional training, or work experience which demonstrates the ability to perform the duties of the position will be considered.

GENERAL KNOWLEDGE, SKILLS & ABILITIES:

• Ability to express thoughts clearly, concisely, and effectively both verbally and in writing. Excellent verbal and written communication skills as well as listening skills and reading and writing comprehension to technical and non-technical audiences of various levels within the organization (e.g., executive, management, individual contributors).
• Excellent problem solving, time management, and work prioritization skills.
• Self-starter with experience handling high work volume and multiple projects.
• Ability to establish and maintain positive relationships with internal and external customers and be a team player.
• Ability to think and use independent judgment effectively in a high-pressure environment. Comfortable with change and possesses the ability to switch tasks and priorities seamlessly.
• Ability to adapt behavior in response to new information or changing circumstances. Is open to change and new information, ideas, methods, or approaches. Work and collaborate effectively and adjusts to original objective or plan to allow for the best possible results.
• Demonstrates active listening and gives full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, not interrupting at inappropriate times, understanding the implications of new information for both current and future problem-solving
• Must be able to successfully maintain multiple projects simultaneously, manage and meet multiple deadlines, be detail-oriented, and possess strong organizational skills.
• Ability to assume responsibility and exercise good judgment in making decisions within the scope of authority of the position.
• Maintains compliance with One Call's established provider data management processes and procedures. Meets client expectations and department accuracy and timeliness commitments. Complies with Accreditation and Regulatory Standards in addition to compliance with State and Federal Accreditation Standards and Regulatory Requirements.
• Ethical conduct and the ability to respect and preserve confidential information entrusted in the course of professional duties is necessary. Reveals confidential information only to appropriate parties and in accordance with any applicable law. Maintains confidentiality regarding legal matters, privacy issues, information technology, and data integrity.
• Performs other related duties as assigned.
• Work collaboratively and relate effectively to others by practicing, valuing, and embracing diversity of individuals, and fostering respect and equity in the workplace.