Senior Provider Data Integrity Specialist

CareMore Health; California (MO); On-site; USD 55,000 - 82,000; Full time

Job summary

CareMore Health is seeking a Network Data Management Specialist III to manage provider and network information across enterprise systems. You will enter, validate, and maintain provider data, ensuring accuracy and regulatory compliance while supporting directories and claims processing.

You will collaborate with Contracting, Credentialing, and Provider Relations, guiding teammates and addressing non-routine issues to improve data quality and operational efficiency.

Qualifications

• 3+ years of provider data management, managed care, healthcare operations, or related experience.
• Excellent attention to detail with the ability to process large volumes of provider data accurately.

Responsibilities

• Process provider data transactions across multiple systems by entering, updating, validating, and maintaining information.
• Review provider demographic, contractual, credentialing, and network information for accuracy and completeness, resolving discrepancies.
• Perform provider data quality reviews to support directories, claims processing, and regulatory reporting.
• Coordinate corrections with internal teams following established workflows.
• Maintain provider data documentation and processing records.

Skills

Provider data management

Data entry

Healthcare operations

Attention to detail

Communication

Education

Associate's or Bachelor's preferred

Tools

Provider data systems

Job description

CareMore Health is seeking a Network Data Management Specialist III to manage provider and network information across enterprise systems. You will enter, validate, and maintain provider data, ensuring accuracy and regulatory compliance while supporting directories and claims processing.

You will collaborate with Contracting, Credentialing, and Provider Relations, guiding teammates and addressing non-routine issues to improve data quality and operational efficiency.