Senior Coordinator, Provider Data Services

Job not on LinkedIn

🔥 3 hours ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $18 - $35 / hour

⏰ Full Time

🟠 Senior

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Maintain and update provider demographic, affiliation, network participation, and credentialing-related information within provider data systems • Process provider additions, changes, terminations, and contract relationship updates • Research and resolve provider data discrepancies, validation failures, and complex service requests • Coordinate with Network Management, Credentialing, Provider Relations, Operations, and other internal stakeholders • Support provider directory accuracy initiatives and regulatory and business requirements • Perform quality reviews, audits, and validation activities to ensure data integrity • Serve as a subject matter expert and provide guidance to peers on provider data maintenance and system workflows • Monitor assigned work queues and meet productivity, quality, and service level expectations • Identify process improvement and operational efficiency opportunities • Support special projects, system implementations, and regulatory readiness activities • Perform other duties as assigned

🎯 Requirements

• 1+ years of experience in provider data management, provider network administration, credentialing, and/or a related healthcare support function • 1+ years of experience maintaining and validating data within healthcare systems and databases • Experience working with established policies, procedures, and quality standards • Demonstrated proficiency with Microsoft Office applications, including Excel • Must reside in Arizona • Strong analytical and problem-solving skills • Attention to detail and commitment to data accuracy • Ability to manage multiple priorities in a fast-paced environment • Strong verbal and written communication skills • Ability to collaborate effectively with cross-functional partners and stakeholders • Experience in a managed care, health plan, payer, or provider network environment • Knowledge of provider data systems such as QNXT, Facets, or similar platforms • Understanding of provider directory requirements, provider contracting, credentialing, and provider onboarding processes • Experience performing quality audits, data validation, and root cause analysis • Prior experience serving as a mentor, trainer, or subject matter expert • Knowledge of healthcare regulatory requirements related to provider data accuracy and maintenance • Experience supporting Medicaid, Medicare, or Commercial lines of business • High school diploma or GED

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being, based on eligibility