Provider Data Management Specialist

Imagine360 is seeking a Provider Data Management Specialist to join the team!  The Provider Data Management Specialist is responsible for installation and ongoing maintenance of contracted provider data. This directly impacts the experience of the members, providers, and third-party administrators that access contracted providers and utilize provider look-up data.

Position Location: 100% remote

Responsibilities include but are not limited to:

• Set up and load systems with new provider demographic information once contract is executed with the provider.
• Experience using SQL and data analytic tools for reporting and data analysis.
• Ensure the data loads meet quality standards. Participate in testing and audit activities related to data integrity and accuracy.
• Monitor and update data based on revised rosters received from health systems and other contracted providers in a timely manner.
• Ensure organized storage of all relevant provider documents.
• Investigates and resolves provider file inaccuracies and discrepancies, coordinating with other departments as necessary.
• Interact with provider offices to verify updates to provider information.
• Assist with provider education efforts on contracted status inquiries.
• Support provider contracting department with issue resolution and data needs as appropriate.
• Coordinate with Credentialing department to identify and update provider data based on provider credentialing efforts.
• Understanding department, segment, and organizational strategy and operating objectives, including their linkages to related areas.
• Provide feedback on system limitations or expansion needs as a user of provider management database. Participate in any testing and validation of system changes and improvements.
• Other duties as assigned.

Required Experience/Education:

• Associate Degree or relevant experience
• Previous provider data loading and maintenance
• Previous health insurance/network experience

Skills and Abilities:

• Proficient in the MS Office Suite to include MS Word, Excel and Outlook
• Excellent organizational, interpersonal, presentation, facilitation, and communication skills
• Demonstrated commitment to high professional ethical standards
• Ability to adapt to a fast paced, continually changing business and work environment while managing multiple priorities
• Excellent follow-through skills, self-motivated and detail-oriented
• Strong organizational skills to manage multiple projects, issues, and priorities effectively and simultaneously, with attention to detail

What can Imagine360 offer you?

• Multiple Health plan options
• Company paid employee premiums for disability and life insurance
• Parental Leave Policy
• 20 days PTO to start / 10 Paid Holidays
• Tuition reimbursement
• 401k Company contribution
• Company paid Short & Long term Disability plus Life Insurance
• Professional development initiatives / continuous learning opportunities
• Opportunities to participate in and support the company's diversity and inclusion initiatives

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Imagine360 is a health plan solution company that combines 50+ years of self-funding healthcare expertise. Over the years, we've helped thousands of employers save billions on healthcare. Our breakthrough total health plan solution is fixing today's one-size-fits-none PPO insurance problems with powerful, customized, member-focused solutions.

Imagine360 is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.

**RECRUITMENT AGENCIES PLEASE NOTE: Imagine360 will only accept applications from agencies/business partners that have been invited to work on a specific role. Candidate Resumes/CV's submitted without permission or directly to Hiring Managers will be considered unsolicited and no fee will be payable. Thank you for your cooperation**