Provider Contract & Data Management Specialist
· Maintain and update provider data applications and coordinate the data verification process for
· providers enrolled in networks.
· Oversee and coordinate operational and administrative activities associated with provider relations, including provider education and liaison responsibilities, marketing and promotion, and facilitation of credentialing and certification.
· Manage and resolve complex provider data issues, such as mass change updates, limited reconciliations and direct submissions of urgent requests.
· Coordinate provider data between the health plan database and various external vendors and internal business systems.
· Participate in the reconciliation and provider data projects.
· Oversee the provider termination process including adding and changing new or existing provider records in the medical information system.