Provider Data Management Specialist

Beth Israel Lahey Health•Wakefield, MA

3d•$25 - $38

About The Position

The Provider Data Management Specialist administers, maintains, supports, and optimizes database systems used for provider credentialing, privileging, and enrollment. The position is the primary functional and technical resource for credentialing-related databases and is responsible for data integrity, system effectiveness, reporting accuracy, and compliance with organizational and regulatory requirements. The specialist works with internal stakeholders, vendors, and information systems teams to support provider data management and operational processes. The role also supports CAQH data and provider enrollment platforms; data governance and audits; NCQA, CMS, and accreditation reporting; provider directory data integrity; and operations across Credentialing, Enrollment, and Facility Credentialing. It provides routine and ad hoc reporting, data analysis and validation, user training, and support for system implementations, upgrades, testing, and process improvements. The position maintains confidentiality, privacy, and security requirements, participates in quality initiatives and departmental projects, completes required education and training, and performs other duties as assigned.

Requirements

High school diploma or GED required.
Knowledge of credentialing, privileging, provider enrollment, and practitioner data management processes in a healthcare environment.
Strong understanding of database management principles and system administration.
Advanced analytical and reporting skills, including data collection, validation, management, and presentation.
Excellent written, verbal, organizational, and interpersonal communication skills.
Ability to prioritize multiple assignments and work independently in a fast-paced healthcare environment.
Proficiency with Microsoft Office Suite, including Excel reporting and data analysis tools.
Must meet the employer's requirement that all staff be vaccinated against influenza as a condition of employment.

Nice To Haves

Associate degree in Computer Science, Information Technology, Health Information Management, Business Administration, or a closely related field.
Knowledge of MD-Staff credentialing software and associated applications.
Experience supporting MD-Staff system administration, provider data management, reporting, workflow configuration, and credentialing database maintenance.
Experience supporting application management, testing, and project implementation activities.

Responsibilities

Administer and maintain databases used for credentialing, privileging, and provider enrollment operations.
Serve as the functional and technical subject matter expert for credentialing database applications.
Monitor system performance and data quality to ensure accurate, timely, and reliable information.
Coordinate with software vendors and information technology teams on system enhancements, upgrades, troubleshooting, and issue resolution.
Maintain database integrity, security, confidentiality, and compliance with organizational policies and standards.
Develop, maintain, and update system configurations, forms, templates, rosters, reports, and tracking mechanisms.
Support CAQH data and provider enrollment platform management.
Support data governance, audits, NCQA/CMS/accreditation reporting, and provider directory data integrity.
Provide cross-functional support for Credentialing, Enrollment, and Facility Credentialing operations.
Generate routine and ad hoc reports for operational, regulatory, and leadership needs.
Analyze and validate provider and credentialing data for business decision-making and compliance activities.
Develop reports and data extracts for credentialing, privileging, enrollment, and operational initiatives.
Maintain accurate provider data and support data governance efforts.
Train and provide ongoing support to database users.
Act as a liaison among Medical Staff Services personnel, operational leaders, information systems teams, and external vendors.
Support system implementations, upgrades, testing, and process improvement initiatives.
Promote excellent customer service and collaborative relationships with internal and external stakeholders.
Maintain compliance with organizational confidentiality, privacy, and security requirements.
Participate in quality improvement initiatives and departmental projects; complete required education and training.
Adhere to BILH and BILHPN policies and customer service standards, maintain courteous and effective interactions, and complete other duties or special projects as assigned.