Senior Provider Data Management Specialist

CareMore Health Management Services, LLC; San Francisco (CA); On-site; USD 55,000 - 82,000; Full time

Job summary

CareMore Health Management Services, LLC in San Francisco is seeking an experienced Network Data Management Specialist III to ensure accuracy and integrity of provider and network information across core systems. You will process provider data transactions, validate records, and resolve non-routine discrepancies following established workflows.

The role partners with Contracting, Credentialing, Provider Relations and other teams to support accurate provider directories, claims processing, and

Qualifications

• 3+ years of provider data management, managed care, healthcare operations or related experience.
• Working knowledge of provider data management processes and provider directory maintenance.
• Experience with provider data entry, validation, reconciliation and maintenance within provider data management systems.
• Excellent attention to detail and ability to process large volumes of data following procedures.
• Strong written and verbal communication and collaboration with internal stakeholders.
• Proficiency with Microsoft Office and provider data management systems; reporting tools preferred.

Responsibilities

• Process provider data transactions across multiple systems: enter, update, validate, maintain.
• Review provider demographic, contractual, credentialing, and network information for accuracy and completeness; resolve non-routine discrepancies.
• Perform provider data quality reviews to support accurate directories, claims processing, and regulatory reporting.
• Research discrepancies and coordinate corrections with internal teams following workflows.
• Maintain provider data documentation and processing records per procedures and quality standards.
• Provide day-to-day guidance to peers on data entry procedures and system navigation.

Skills

Provider data management

Healthcare operations

Data quality

Education

Associate's/Bachelor's preferred

Tools

Microsoft Office

Provider data systems

Job description

CareMore Health Management Services, LLC in San Francisco is seeking an experienced Network Data Management Specialist III to ensure accuracy and integrity of provider and network information across core systems. You will process provider data transactions, validate records, and resolve non-routine discrepancies following established workflows.

The role partners with Contracting, Credentialing, Provider Relations and other teams to support accurate provider directories, claims processing, and