Provider Data Coordinator

Sante Health•Fresno, CA

22d•Onsite

About The Position

The Provider Data Coordinator supports the Provider Credentialing department at Santé Health System in Fresno, California. This full-time, non-remote position coordinates provider demographic data and ensures changes are processed promptly and accurately, data remains accurate, and applicable regulatory requirements are met. The role serves as a liaison among health plans, providers, and internal staff; maintains provider demographic records used for health plan rosters and directories; and supports credentialing initiatives through data entry, roster audits, and provider roster maintenance. The coordinator also generates reports, assists with data validation, responds to health plan inquiries, and participates in health plan meetings and cross-functional projects affecting Provider Credentialing.

Requirements

High school diploma or GED equivalent.
Three years of experience in data analytics, including at least one year in a healthcare setting preferred.
Experience and working knowledge of clinic operations.
Proficiency with Microsoft Office, primarily Microsoft Excel.
Working knowledge of the managed care environment and associated lines of business, such as HMO, Commercial, Medicare, and Medicaid.
Working knowledge of the MD Staff platform and related systems and software technologies.
Ability to exercise initiative, judgment, and decision-making.
Knowledge of the local provider market.
Ability to work independently and as a team member.
Excellent time management, multitasking, and prioritization skills.
Ability to communicate effectively with varied professional audiences.
Ability to assimilate and present information logically.
Ability to read, analyze, and interpret provider demographic data.

Nice To Haves

Knowledge of database software applications is a plus.

Responsibilities

Serve as a liaison between health plans, providers, and internal staff to process, review, and communicate provider demographic data.
Maintain provider database and demographic data for health plan rosters and directories, ensuring data accurately reflects provider participation on panels.
Communicate demographic changes to health plans and internal staff using template reports.
Generate routine and ad hoc reports for appropriate staff or delegated groups.
Assist health plans with quarterly data validation queries.
Respond to health plan inquiries related to provider demographic data.
Use existing data systems and applications effectively.
Mine, summarize, validate, and maintain the integrity of provider demographic data.
Support Provider Credentialing initiatives, including data entry, roster audits, and maintenance of the overall provider roster.
Participate in health plan meetings as the IPA's representative.
Participate in cross-functional projects that affect Provider Credentialing.
Perform other job-related duties as requested.