Provider Data Services, Senior Coordinator (Must reside in Arizona)

CVS Health•Work At Home-Arizona, AZ

1d•$19 - $35•Remote

About The Position

The Provider Data Services, Senior Coordinator is responsible for maintaining the accuracy, integrity, and completion of provider data across enterprise systems. This person supports provider onboarding, demographic maintenance, contract and affiliation updates, provider directory accuracy initiatives, and operational audits. The Provider Data Services, Senior Coordinator serves as a subject matter resource, performs complex provider data research, resolves data discrepancies, coordinates with Network Management and other business partners, and ensures provider records comply with internal standards and regulatory requirements.

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 and information within healthcare systems and databases, as well as working with established policies, procedures, and quality standards.
Demonstrated proficiency with Microsoft Office applications, including Excel.
Must reside in Arizona.

Nice To Haves

Strong analytical and problem-solving skills, with the ability to research and resolve complex issues.
Demonstrated 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 working in a managed care, health plan, payer, or provider network environment.
Knowledge of provider data systems such as QNXT, Facets, or similar provider maintenance 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.

Responsibilities

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 in accordance with established procedures.
Research and resolve provider data discrepancies, validation failures, and complex service requests.
Coordinate with Network Management, Credentialing, Provider Relations, Operations, and other internal stakeholders to obtain missing information and ensure accurate provider records.
Support provider directory accuracy initiatives and ensure provider information is maintained in accordance with regulatory and business requirements.
Perform quality reviews, audits, and validation activities to ensure data integrity across systems.
Serve as a subject matter expert and provide guidance to peers regarding provider data maintenance processes and system workflows.
Monitor assigned work queues and meet departmental productivity, quality, and service level expectations.
Identify trends and opportunities for process improvement and operational efficiency.
Support special projects, system implementations, and regulatory readiness activities as assigned.
Perform other duties as assigned.