Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living.

Summary:
The Provider Data Maintenance Operator assists the Provider Data Maintenance Supervisor with any of the following: provider demographic updates, contract updates, fee schedule updates, auditing, running reports, etc. The Operator will typically be assigned as a lead on any special projects that may arise.

Primary Responsibilities:
The Provider Data Maintenance Operator is responsible for, but not limited to:

• Creation and maintenance of all provider records within the health plan system(s). Includes setup of demographic and specialty information, panel, line of business and fee schedules.
• Performs data entry accurately and timely.
• Audit current provider contracts and data to ensure they are up to date.
• Act as SME for other departments as it relates to provider contracts and setup
• Trouble shoot and identify root cause of problems and collaborate with other departments to resolve. Identifies and documents opportunities for provider education.
• Participates in standing meetings as necessary, including but not limited to provider relations, contracting, network development, team building.
• Performs other duties and special projects as assigned and directed.

Specific Technical Skills

Required:

• Proficiency with MS applications, including but not limited to Word, Excel and Outlook.

Knowledge and Skills:

• Detail oriented, excellent follow up
• Excellent verbal and written communication skills
• Ability to multi-task in a fast-paced environment
• Must be service oriented, quick learner, team player
• Appreciation of cultural diversity and sensitivity toward target population

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, and photocopiers.

Education and Experience

Education

Preferred: BA/BS degree in a financial field or equivalent healthcare experience

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment.


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