Provider Data Integrity Supervisor

LSMA Management IncSan Bernardino, CA
40mHybrid

About The Position

The Provider Data Integrity Supervisor is responsible for overseeing the accuracy, integrity, and maintenance of provider demographic, contractual, and network participation data across all organizational systems and health plan reporting platforms. This role supervises Provider Data Integrity staff and ensures compliance with regulatory requirements, health plan contractual obligations, and accreditation standards, including DMHC, CMS, DHCS, and NCQA requirements. The Supervisor ensures timely and accurate provider data entry, provider roster submissions, provider directory accuracy, and provider system updates to support network operations, claims processing, member access, and regulatory compliance. This role works closely with Credentialing, Provider Relations, Contracting, Health Plan Operations, and IT teams to maintain data accuracy and operational readiness.

Requirements

  • Associate’s degree or equivalent.
  • 4+ years of provider data management, credentialing, or managed care operations experience.
  • Strong knowledge of provider data management and healthcare provider systems.
  • Knowledge of DMHC, CMS, DHCS, and NCQA provider data requirements.
  • Strong leadership and staff management skills.
  • Proficiency with provider management systems such as EZ Cap, EPIC, or similar.
  • Strong analytical, organizational, and problem-solving skills.
  • Excellent communication and interpersonal skills.
  • Ability to maintain confidentiality and data integrity.

Nice To Haves

  • Bachelor’s degree in Healthcare Administration, Business Administration, or related field.
  • Experience in MSO, IPA, or health plan environment.
  • Experience supporting delegated managed care operations and audits.

Responsibilities

  • Overseeing the accuracy, integrity, and maintenance of provider demographic, contractual, and network participation data
  • Supervising Provider Data Integrity staff
  • Ensuring compliance with regulatory requirements, health plan contractual obligations, and accreditation standards
  • Ensuring timely and accurate provider data entry, provider roster submissions, provider directory accuracy, and provider system updates
  • Working closely with Credentialing, Provider Relations, Contracting, Health Plan Operations, and IT teams to maintain data accuracy and operational readiness
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