Provider Network Data & Configuration Lead

Consociate Health; Decatur (IL); Hybrid; USD 110,000 - 140,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Dental insurance

Disability insurance

Employee assistance program

Flexible spending account

Health insurance

Health savings account

Life insurance

Paid time off

Paid training

Vision insurance

Job summary

Consociate Health is seeking a Network Contract Maintenance Manager to oversee provider data functions within a TPA environment. You will manage provider information, fee schedules, and contract configurations, acting as the liaison between internal teams and external partners.

The role requires 5+ years in provider data management or similar, with strong analytical and leadership skills. Hybrid work options are available, with on-site collaboration as needed.

Qualifications

• Bachelor’s degree in Healthcare Administration, Business, Information Systems, or related field; or equivalent experience.
• 5+ years of provider data management, network configuration, or network operations within a TPA, health plan, PPO network, or similar environment.
• Strong understanding of provider network structures, provider reimbursement methodologies, and how configurations impact claims adjudication.

Responsibilities

• Oversee provider data management, including collection, validation, and maintenance of provider information and contracts.
• Manage loading of network configurations, fee schedules, provider pricing, and reimbursement logic into systems.
• Coordinate with IT and external partners to troubleshoot provider data issues and lead UAT for new functionality.
• Serve as the primary contact for external network partners and repricing vendors regarding rosters and contract management.
• Lead and develop a team of provider data analysts and configuration specialists; establish metrics and SOPs.

Skills

Data management

Contract management

Leadership

Team coaching

Analytical thinking

Communication

Education

Bachelor’s degree in healthcare administration or related field

Tools

Provider databases

Claims systems

Configuration platforms

Job description

Consociate Health is seeking a Network Contract Maintenance Manager to oversee provider data functions within a TPA environment. You will manage provider information, fee schedules, and contract configurations, acting as the liaison between internal teams and external partners.

The role requires 5+ years in provider data management or similar, with strong analytical and leadership skills. Hybrid work options are available, with on-site collaboration as needed.