Remote Senior Provider Data Operations Coordinator

University of California; Orange (CA); On-site; USD 56,000 - 84,000; Full time

Benefits offered by this job

Comprehensive benefits package

CalPERS pension program

Full Telework

Job summary

CalOptima Health seeks a Provider Data Management Services Coordinator Sr to build and maintain provider records in the CalOptima Health provider system. You will act as a liaison between health networks and providers to ensure data accuracy across databases and directories.

Role includes leading projects, coordinating with teams, training new staff, and resolving complex data issues within the PDO department. Full telework is approved with California in-office requirements as needed.

Qualifications

• High school diploma or equivalent PLUS 3 years of general data management experience in automated claims processing, claims research or provider maintenance environment/managed care organization required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• 2 years of experience in provider relations, provider contracting, health plan operations or other health care/medical office environment required.

Responsibilities

• Maintain, update and ensure accuracy of provider records in CalOptima Health systems.
• Serve as liaison between health networks and providers to support data quality and directory accuracy.
• Lead projects and coordinate work with team members to meet timelines.
• Train new staff and provide ongoing guidance on data operations.
• Escalate complex data issues and collaborate to resolve them.

Skills

Data management

Provider relations

Communication

Project coordination

Education

High school diploma or equivalent

Bachelor's degree in healthcare admin or related field

Tools

Facets (TriZetto)

Job description

CalOptima Health seeks a Provider Data Management Services Coordinator Sr to build and maintain provider records in the CalOptima Health provider system. You will act as a liaison between health networks and providers to ensure data accuracy across databases and directories.

Role includes leading projects, coordinating with teams, training new staff, and resolving complex data issues within the PDO department. Full telework is approved with California in-office requirements as needed.