Provider Data Management Specialist

Provider Data Management Specialist

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings.

The Clinical Integration (CI) and Accountable Care Organization (ACO) programs are clinically integrated physician networks sponsored by Dignity Health (DH). In order to fill service gaps in a CI / ACO Network, a complementary network of ancillary providers is maintained in each region. The Provider Data Management Specialist is an employee of Dignity Health Management Service.

Under the direction of the Manager, this individual :

• provides data management support services to Dignity Health's CI / ACO Networks Employer Relations and Valued Based Operations (VBO)
• within the Salesforce platform, this individual gathers and maintains accurate provider data, 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's team.

The Provider Data Management Specialist also supports network development to ensure the integrity, accuracy, and completeness of provider information across internal systems, enabling efficient operations, compliance, and network performance. This role is foundational to the success of network optimization efforts in each of the national Value-Hub markets.

Job Requirements

Minimum Qualifications :

Preferred Qualifications :

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.

Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https : / / www.commonspirit.careers / benefits .

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.