Provider Engagement & Data Specialist

Community Health Network of Connecticut, Inc.; Wallingford (CT); On-site; USD 28,000 - 36,000; Full time

Job summary

Community Health Network of Connecticut, Inc. in Wallingford, CT is seeking a Network Internal Representative to support provider/hospital data maintenance, recruitment, and grievance resolution.

The role requires strong data entry skills, Medicaid experience, and proficiency with CACTUS/sProvider and CRM systems. The position is regular full-time on-site, with responsibilities ranging from data maintenance to outreach activities and collaboration with the PES and CMAP networks.

Qualifications

• Must have 5 years Medicaid/administrative experience.
• Strong customer and provider telephone/email handling.
• Knowledge of CMAP networks and CACTUS/sProvider.
• Proficient with Microsoft Office and CRM systems.

Responsibilities

• Verify, analyze, and maintain provider/hospital data to support the member/provider directory.
• Recruit instate and out-of-state providers by telephonic and email outreach.
• Recruit CMAP providers for re-enrollment within 60 days of DSS termination.
• Monitor provider grievances and input data into CRM and CACTUS/sProvider.

Skills

Data entry

Phone and email outreach

Provider engagement

CRM systems

Microsoft Office

Education

High school diploma or GED

Secondary schooling or vocational training

College level degree preferred

Tools

CACTUS/sProvider

Interchange

CRM

Microsoft Office

Job description

Community Health Network of Connecticut, Inc. in Wallingford, CT is seeking a Network Internal Representative to support provider/hospital data maintenance, recruitment, and grievance resolution.

The role requires strong data entry skills, Medicaid experience, and proficiency with CACTUS/sProvider and CRM systems. The position is regular full-time on-site, with responsibilities ranging from data maintenance to outreach activities and collaboration with the PES and CMAP networks.