Provider Data Management Specialist I

Provider Data Management Specialist I
USA-Georgia-Atlanta
Position Purpose: Maintain accurate databases and reports to monitor
network compliance with State requirements

• Create and maintain multiple databases, including, contract

provider network, prior authorization, third party liability,
provider set ups and related corrections

• Oversee the provider termination process including adding and

changing new or existing provider records in the medical
information system

• Schedule monthly provider verifications regarding provider

enrollment specifications and demographic changes

• Update delegated provider Medicare and Medicaid documents on a

monthly and ad hoc basis and ensure state compliance

• Provide appropriate reports and statistical data to other

department designees for review, follow-up and resolution

• Perform general administrative tasks in support of assigned

department
Education/Experience: High school diploma or equivalent. 2+ years of
provider data or network administration experience, preferably in a
managed care setting. Proficient in Microsoft Office applications,
preferably Access and Excel. Previous experience with database
management, reporting and analysis preferred. Associate s degree in
health care or a related field preferred.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment without
regard to race, color, religion, sex, sexual orientation, gender
identity, national origin, disability, veteran status, or other
characteristic protected by applicable law.
Network Development & Contracting
Full-time

Resume Library