Senior Coordinator, Provider Data Services

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Maintain and refresh provider demographic data, affiliation details, network participation, and credentialing-related information within provider data systems.

• Handle provider additions, modifications, terminations, and updates regarding contract relationships.

• Investigate and resolve discrepancies in provider data, validation failures, and intricate service requests.

• Collaborate with Network Management, Credentialing, Provider Relations, Operations, and other internal teams.

• Assist in initiatives aimed at ensuring the accuracy of provider directories along with meeting regulatory and business requirements.

• Conduct quality reviews, audits, and validation tasks to uphold data integrity.

• Act as a subject matter expert and offer guidance to colleagues on provider data maintenance and system workflows.

• Oversee assigned work queues and achieve productivity, quality, and service level targets.

• Identify opportunities for process enhancements and operational efficiencies.

• Support special projects, system implementations, and activities related to regulatory readiness.

• Execute additional tasks as assigned.

⛳️ Requirements

• A minimum of 1 year of experience in provider data management, provider network administration, credentialing, or a related healthcare support role.

• At least 1 year of experience in maintaining and validating data within healthcare systems and databases.

• Familiarity with established policies, procedures, and quality standards.

• Proven proficiency in Microsoft Office applications, particularly Excel.

• Must be a resident of Arizona.

• Strong analytical and problem-solving abilities.

• High attention to detail and a commitment to data accuracy.

• Capability to manage multiple priorities in a fast-paced setting.

• Excellent verbal and written communication skills.

• Ability to effectively collaborate with cross-functional partners and stakeholders.

• Experience in a managed care, health plan, payer, or provider network context.

• Knowledge of provider data systems such as QNXT, Facets, or similar platforms.

• Understanding of provider directory requirements, provider contracting, credentialing, and onboarding processes.

• Experience in executing quality audits, data validation, and root cause analysis.

• Previous experience as a mentor, trainer, or subject matter expert.

• Awareness of healthcare regulatory requirements concerning provider data accuracy and maintenance.

• Experience supporting Medicaid, Medicare, or Commercial lines of business.

• High school diploma or GED.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being, subject to eligibility.