Data Management Specialist

Community Health Plan of Imperial Valley • Imperial, CA

1d • $85,000

About The Position

Community Health Plan of Imperial Valley (CHPIV) is Imperial County's Medi-Cal managed care plan. We are a locally managed public health care plan committed to working with members, providers, and the residents of Imperial County.
Our team is growing, and we’re looking for a Data Management Specialist to ensure the accuracy, completeness, and reliability of provider, enrollment, and related healthcare data.
Our next team member will do the following:
Data Accuracy and Reconciliation: Monitor, review, and validate provider and enrollment data across delegated partners and systems to ensure data integrity and compliance with internal and external regulations. This includes:
Validating member assignments to providers, documenting and reporting changes, and reconciling delegate files, reports, and databases.
Validating provider assignments to Independent Physician Associations and documenting and reporting changes, and reconciling databases.
Data Auditing: Conduct routine audits on external data sets and claim system configuration. This includes manual system checks and data review.
Data Automation: Writing scripts to automate provider directory data controls: detect data anomalies/duplicates and reconcile across multiple sources.
Reporting and Documentation: Generate accurate reporting for internal performance tracking, regulatory reporting, and quality assurance initiatives.
System and Process Support: Act as a liaison between the health plan, internal teams, IT, and delegated entities to support system updates, data migrations, and workflow improvements. This includes serving as the internal subject matter expert on provider and enrollment data specifications to inform data warehouse development and reporting.
Training and Guidance: Provide end-user support and training for staff and delegated partners on data processes and standards.
Compliance and Quality Assurance: Ensure adherence to policies, federal and state regulations, and organizational standards for data management, including HIPAA and accreditation requirements

Requirements

• Bachelor’s degree in Health Information Management, Business, Computer Science, or related field, or equivalent experience
• 2–5 years of experience in healthcare data management, enrollment processing, or related administrative roles
• Advanced skills in SQL, Microsoft Excel/Access, Tableau, Power BI, or statistical tools (e.g., SAS, Python, R) are required.

Nice To Haves

• Preference will be given to candidates who are local to Imperial, California.

Responsibilities

• Monitor, review, and validate provider and enrollment data across delegated partners and systems to ensure data integrity and compliance with internal and external regulations.
• Validating member assignments to providers, documenting and reporting changes, and reconciling delegate files, reports, and databases.
• Validating provider assignments to Independent Physician Associations and documenting and reporting changes, and reconciling databases.
• Conduct routine audits on external data sets and claim system configuration. This includes manual system checks and data review.
• Writing scripts to automate provider directory data controls: detect data anomalies/duplicates and reconcile across multiple sources.
• Generate accurate reporting for internal performance tracking, regulatory reporting, and quality assurance initiatives.
• Act as a liaison between the health plan, internal teams, IT, and delegated entities to support system updates, data migrations, and workflow improvements.
• Serve as the internal subject matter expert on provider and enrollment data specifications to inform data warehouse development and reporting.
• Provide end-user support and training for staff and delegated partners on data processes and standards.
• Ensure adherence to policies, federal and state regulations, and organizational standards for data management, including HIPAA and accreditation requirements

Benefits

• A competitive salary starting at $85,000/ year.
• Health, dental, and vision insurance that is paid for 85% for you and your family
• Paid time off
• A 401k plan with a generous match
• A chance to make a real difference in the Imperial Valley community

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1-10 employees