CommonSpirit Health
Provider Data Management Specialist
CommonSpirit Health, Bakersfield, California, United States, 93399
Where You’ll Work:
The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician‑centric, full‑service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry‑leading technology and integrated administrative systems powered by local human resources that put patient care first. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state‑of‑the‑art, flexible Health & Welfare benefits package.
Our cafeteria‑style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer‑match. Other benefits include Paid Time Off and Sick Leave.
Job Summary and Responsibilities
Provides data management support services to Dignity Health’s CI/ACO Networks, Employer Relations and Valued Based Operations (VBO)
Gathers and maintains accurate provider data within the Salesforce platform, performs periodic provider data reconciliations with multiple data sources, including 3rd‑party payors
Generates reporting on the provider network
Conducts review of network adequacy and capabilities
Maintains and transmits fee schedules, as necessary, to third‑party administrators (TPA’s) and other appropriate stakeholders
Provides customer support services to Dignity Health CI/ACO Networks and VBO team
Supports network development to ensure the integrity, accuracy, and completeness of provider information across internal systems, enabling efficient operations, compliance, and network performance
Ensures network optimization efforts in each of the national Value-Hub markets
This position is remote, but will be expected to work PST business hours.
Job Requirements: Minimum Qualifications
Minimum 3 years’ experience in provider relations, provider credentialing, provider database maintenance and reporting, provider contracting and/or network development in a health care or managed care setting
High school diploma or GED
Demonstrated skills in written and verbal communication, judgment, and problem‑solving
Strong proficiency in Microsoft Office products
Highly motivated with exceptional customer service, relationship management and interpersonal skills
Attention to detail
Capable of independent thinking and performing in a team environment
Preferred Qualifications
Bachelor’s degree in Business, Finance, Health Care Management, Economics, or a related field
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The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician‑centric, full‑service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry‑leading technology and integrated administrative systems powered by local human resources that put patient care first. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state‑of‑the‑art, flexible Health & Welfare benefits package.
Our cafeteria‑style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer‑match. Other benefits include Paid Time Off and Sick Leave.
Job Summary and Responsibilities
Provides data management support services to Dignity Health’s CI/ACO Networks, Employer Relations and Valued Based Operations (VBO)
Gathers and maintains accurate provider data within the Salesforce platform, performs periodic provider data reconciliations with multiple data sources, including 3rd‑party payors
Generates reporting on the provider network
Conducts review of network adequacy and capabilities
Maintains and transmits fee schedules, as necessary, to third‑party administrators (TPA’s) and other appropriate stakeholders
Provides customer support services to Dignity Health CI/ACO Networks and VBO team
Supports network development to ensure the integrity, accuracy, and completeness of provider information across internal systems, enabling efficient operations, compliance, and network performance
Ensures network optimization efforts in each of the national Value-Hub markets
This position is remote, but will be expected to work PST business hours.
Job Requirements: Minimum Qualifications
Minimum 3 years’ experience in provider relations, provider credentialing, provider database maintenance and reporting, provider contracting and/or network development in a health care or managed care setting
High school diploma or GED
Demonstrated skills in written and verbal communication, judgment, and problem‑solving
Strong proficiency in Microsoft Office products
Highly motivated with exceptional customer service, relationship management and interpersonal skills
Attention to detail
Capable of independent thinking and performing in a team environment
Preferred Qualifications
Bachelor’s degree in Business, Finance, Health Care Management, Economics, or a related field
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