IPA Provider Data Coordinator
3 weeks ago
Job Summary
Sante Health System is seeking a skilled IPA Provider Data Coordinator to join our team. As a key liaison between health plans, providers, and internal staff, you will be responsible for processing, reviewing, and communicating provider demographic data.
Key Responsibilities
- Maintain provider database and demographic data for health plan rosters/directories, ensuring accurate data reflects provider participation on various panels.
- Communicate demographic changes to health plans and internal staff via template reports.
- Generate reports, both routine and ad hoc, to appropriate staff or delegated groups.
- Assist health plans with quarterly data validation queries.
- Respond to health plan inquiries related to provider demographic data.
- Accountable for optimal usage of existing data systems and applications.
- Data mining, summarizing, validation, and integrity of provider demographic data.
- Support Provider Credentialing initiatives, including data entry, roster audits, and overall provider roster.
- Participate in health plan meetings, serving as the IPA's representative.
About Sante Health System
Sante Health System is a Management Services Organization that serves multiple clients. Our name symbolizes our commitment to good health, progressive care, and leadership in our community. We provide numerous client services, including billing, claims processing, contracting, credentialing, finance, human resources, information services, marketing/communications, physician services, practice management, provider relations, quality improvement, and utilization management.
Requirements
- High School diploma/GED equivalent required.
- Three years' experience in data analytics, including at least one year in a healthcare setting preferred.
- Experience and working knowledge of clinic operations.
- Proficient user of MS Office Suite, primarily Microsoft Excel.
- Working knowledge of managed care environment and associated lines of business, such as HMO/Commercial/Medicare/Medicaid.
- Knowledge of database software applications is a plus.
Success Factors
- Well-developed competencies in areas such as working knowledge of MD Staff platform and related systems and software technologies.
- Ability to exercise initiative, judgment, and decision-making.
- Knowledge of local provider market.
- Ability to work independently and as a team member.
- Excellent time management, multi-tasking, and prioritization skills required.
- Ability to effectively communicate with varied professional audiences.
- Ability to assimilate and present information logically.
- Ability to read, analyze, and interpret provider demographic data.
Why Sante Health System?
We offer competitive pay, excellent benefits, including medical, dental, vision, and life insurance, 401k retirement plan, paid time off, and opportunities for advancement. Our team is comprised of talented, driven, dedicated, innovative, and service-driven professionals who are passionate about enhancing the quality of life of our patients.
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