Senior Provider Data Management Specialist

CareMore Health Management Services, LLC; California (MO); Hybrid; USD 55,000 - 82,000; Full time

Job summary

CareMore Health Management Services, LLC is seeking a Network Data Management Specialist III to manage provider and network information across enterprise systems. You will ensure accuracy and completeness, review credentialing and directory data, and resolve non-routine discrepancies in collaboration with internal teams.

The role requires attention to detail, strong data handling skills, and the ability to guide peers while adhering to regulatory requirements and company standards.

Qualifications

• Associate's or bachelor's degree preferred; high school diploma with relevant experience may be considered.
• 3+ years of provider data management, managed care, healthcare operations, or related experience.
• Strong attention to detail with ability to process large volumes of data.
• Excellent written and verbal communication and collaboration with internal stakeholders.
• Proficiency with MS Office and provider data management systems; reporting/data tools preferred.

Responsibilities

• Process provider data transactions across multiple systems: enter, update, validate, and maintain records.
• Review demographic, contractual, credentialing, and network participation information for accuracy.
• Perform data quality reviews to support directories, claims, and regulatory reporting.
• Research discrepancies and coordinate corrections with internal teams using established workflows.
• Maintain documentation and reference materials in line with procedures and standards.
• Provide day-to-day guidance to teammates on entry procedures and system navigation, acting as a resource.

Skills

Provider data management

Data entry

Data validation

Documentation

Microsoft Office

Collaboration

Education

Associate's or Bachelor's degree preferred

3+ years provider data management experience

Tools

Provider data management systems

Microsoft Office applications

Job description

CareMore Health Management Services, LLC is seeking a Network Data Management Specialist III to manage provider and network information across enterprise systems. You will ensure accuracy and completeness, review credentialing and directory data, and resolve non-routine discrepancies in collaboration with internal teams.

The role requires attention to detail, strong data handling skills, and the ability to guide peers while adhering to regulatory requirements and company standards.