Director, Provider Data Management This position is responsible for enterprise leadership and strategic oversight of CareOregon's provider network data management, including provider data management ...
Director, Provider Data Management This position is responsible for enterprise leadership and strategic oversight of CareOregon's provider network data management, including provider data management ...
Director, Provider Data Management ----- This position is responsible for enterprise leadership and strategic oversight of CareOregon's provider network data management, including provider data ...
Director, Provider Data Management ----- This position is responsible for enterprise leadership and strategic oversight of CareOregon's provider network data management, including provider data ...
Supervisor, Provider Data Management
Troy, NY · On-site
$60K - $65K/yr
Supervisor, Provider Data Management Supervisor, Provider Data Management Who are we? Versant Health is one of the nation's leading administrators of managed vision care, serving millions of our ...
Supervisor, Provider Data Management
Troy, NY · On-site
$60K - $65K/yr
Supervisor, Provider Data Management Supervisor, Provider Data Management Who are we? Versant Health is one of the nation's leading administrators of managed vision care, serving millions of our ...
Supervisor, Provider Data Management
Supervisor, Provider Data Management
Senior Business Analyst, Advanced Provider Data Management
Long Beach, CA · On-site +1
$129K/yr
Job Summary Provides senior level analyst support for advanced provider data management (PDM) activities including analyzing business processes related to PDM, identifying areas for improvement, and ...
Senior Business Analyst, Advanced Provider Data Management
Long Beach, CA · On-site +1
$129K/yr
Job Summary Provides senior level analyst support for advanced provider data management (PDM) activities including analyzing business processes related to PDM, identifying areas for improvement, and ...
The Operations Resolution Specialist - Provider Data Management (PDM), ensures the timely and accurate entry of all add/changes/deletions to the Amisys Provider Database. The PDM Specialist ...
The Operations Resolution Specialist - Provider Data Management (PDM), ensures the timely and accurate entry of all add/changes/deletions to the Amisys Provider Database. The PDM Specialist ...
The Data Analyst will be responsible to provide insight into data trends, drawing broad conclusions and create actionable management reports that can be used to identify opportunities to improve data ...
The Data Analyst will be responsible to provide insight into data trends, drawing broad conclusions and create actionable management reports that can be used to identify opportunities to improve data ...
Senior Analyst, Provider Data Management (SQL/ QNXT)
Long Beach, CA · On-site
$96K - $127K/yr
The Sr. Analyst, Provider Data Management is responsible for analyzing and understanding business processes, identifying areas for improvement, and developing solutions to optimize performance. The ...
Senior Analyst, Provider Data Management (SQL/ QNXT)
Long Beach, CA · On-site
$96K - $127K/yr
The Sr. Analyst, Provider Data Management is responsible for analyzing and understanding business processes, identifying areas for improvement, and developing solutions to optimize performance. The ...
Requires the ability to manage a large amount of complex information, communicate clearly, and draw ... Collaborates with the Provider Data Specialists and provides clear instructions to correct data ...
Requires the ability to manage a large amount of complex information, communicate clearly, and draw ... Collaborates with the Provider Data Specialists and provides clear instructions to correct data ...
Provider Data and Contract Analyst
Hopkins, MN · On-site
$35 - $40/hr
... management, data warehousing, QA, or SQL is preferred. • Prior experience in a health insurance environment is a plus.
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Provider Data and Contract Analyst
Hopkins, MN · On-site
$35 - $40/hr
... management, data warehousing, QA, or SQL is preferred. • Prior experience in a health insurance environment is a plus.
... Management leads enterprise Master Data Management (MDM) and Reference Data Management (RDM ... Lead the enterprise MDM & RDM strategy, roadmap, and execution for member and provider data domains
... Management leads enterprise Master Data Management (MDM) and Reference Data Management (RDM ... Lead the enterprise MDM & RDM strategy, roadmap, and execution for member and provider data domains
Data Management Analyst
Fort Belvoir, VA · On-site
Provides data management and data quality expertise in support of the design, management, and entry of the DOW records. Conducts data quality analysis, validation, and verification. Assists in ...
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Data Management Analyst
Fort Belvoir, VA · On-site
Provides data management and data quality expertise in support of the design, management, and entry of the DOW records. Conducts data quality analysis, validation, and verification. Assists in ...
Provides data management and data quality expertise in support of the design, management, and entry of the DOW records. Conducts data quality analysis, validation, and verification. Assists in ...
Provides data management and data quality expertise in support of the design, management, and entry of the DOW records. Conducts data quality analysis, validation, and verification. Assists in ...
Data Management Specialist
Ridgecrest, CA · On-site
$70K - $80K/yr
Providing Data Management (DM) to the VECTR IPT team. Setting up Azure DevOps as the data management tracking tool. Transferring documents and data to the Azure DevOps environment. Configuring ...
Data Management Specialist
Ridgecrest, CA · On-site
$70K - $80K/yr
Providing Data Management (DM) to the VECTR IPT team. Setting up Azure DevOps as the data management tracking tool. Transferring documents and data to the Azure DevOps environment. Configuring ...
Provide Data Management for the collection, organization, storage, security, and analysis of data to ensure data integrity, accessibility, and compliance with relevant regulations and standards ...
Provide Data Management for the collection, organization, storage, security, and analysis of data to ensure data integrity, accessibility, and compliance with relevant regulations and standards ...
Data Management Specialist
Torrance, CA · On-site
$102K/yr
JOB ANNOUNCEMENT DATA MANAGEMENT SPECIALIST: Assist R&D Director of psychometrics and Project ... Provide data support with a variety of tasks during the data collection phase, including writing ...
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Data Management Specialist
Torrance, CA · On-site
$102K/yr
JOB ANNOUNCEMENT DATA MANAGEMENT SPECIALIST: Assist R&D Director of psychometrics and Project ... Provide data support with a variety of tasks during the data collection phase, including writing ...
Performs complex systems and data analysis to support business operations and technology initiatives, with a strong focus on provider data processes and solutions. Builds, implements, manages, and ...
Performs complex systems and data analysis to support business operations and technology initiatives, with a strong focus on provider data processes and solutions. Builds, implements, manages, and ...
Supervisor, Provider Ops
Phoenix, AZ · On-site
Job Summary Supervises the provider data management, credentialing or contract support teams to ensure that the department is meeting established goals and performance metrics. Oversees the ...
Supervisor, Provider Ops
Phoenix, AZ · On-site
Job Summary Supervises the provider data management, credentialing or contract support teams to ensure that the department is meeting established goals and performance metrics. Oversees the ...
Associate, Provider Data Analytics
Tempe, AZ · Hybrid
$87K - $114K/yr
You will report into the Senior Manager, Provider Data Operations. Work Location: This position is based in our Tempe, Arizona office, requiring a hybrid work schedule with 3 days of in-office work ...
Associate, Provider Data Analytics
Tempe, AZ · Hybrid
$87K - $114K/yr
You will report into the Senior Manager, Provider Data Operations. Work Location: This position is based in our Tempe, Arizona office, requiring a hybrid work schedule with 3 days of in-office work ...
Associate, Provider Data Analytics
Dallas, TX · Remote
$87K - $114K/yr
You will report into the Senior Manager, Provider Data Operations. Work Location: This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our ...
Associate, Provider Data Analytics
Dallas, TX · Remote
$87K - $114K/yr
You will report into the Senior Manager, Provider Data Operations. Work Location: This is a remote position, open to candidates who reside in: Dallas, Texas. You will be fully remote; however, our ...
Provider Data Management information
See salary details
$31K - $43.8K
7% of jobs
$43.8K - $56.6K
8% of jobs
$65.3K is the 25th percentile. Wages below this are outliers.
$56.6K - $69.5K
14% of jobs
$69.5K - $82.3K
18% of jobs
The median wage is $84.6K / yr.
$82.3K - $95.1K
15% of jobs
$95.1K - $107.9K
7% of jobs
$117.5K is the 75th percentile. Wages above this are outliers.
$107.9K - $120.7K
7% of jobs
$120.7K - $133.5K
6% of jobs
$133.5K - $146.4K
6% of jobs
$146.4K - $159.2K
4% of jobs
$159.2K - $172K
6% of jobs
$31K
$97.1K
$172K
How much do provider data management jobs pay per year?
What is a Provider Data Management job?
A Provider Data Management job involves maintaining and updating healthcare provider information in databases to ensure accuracy for insurance companies, health systems, or third-party administrators. Responsibilities include verifying provider credentials, processing updates, and ensuring compliance with regulatory standards. This role helps prevent claim issues, improves provider directory accuracy, and supports efficient healthcare operations. Strong attention to detail, problem-solving skills, and knowledge of healthcare data systems are essential for success in this field.
What are the typical responsibilities of someone working in Provider Data Management?
In a Provider Data Management role, you'll primarily be responsible for maintaining accurate and up-to-date records of healthcare providers, including verifying credentials, onboarding new providers, and managing updates or terminations. You may work closely with credentialing teams, compliance officers, and IT professionals to ensure data aligns with regulatory standards and operational needs. Regular tasks often include data entry, auditing information for accuracy, troubleshooting discrepancies, and communicating with providers to gather or verify important data. This role is integral to supporting healthcare operations, insurance claims, and ensuring that patients have access to approved providers.
What are the key skills and qualifications needed to thrive in the Provider Data Management position, and why are they important?
To thrive in Provider Data Management, you need strong analytical skills, attention to detail, and experience with health care data systems, often supported by a degree in health information management or a related field. Familiarity with provider databases, credentialing software, and industry standards such as HIPAA compliance is typically required. Excellent organizational skills, problem-solving ability, and effective communication help you excel when coordinating with various internal teams and external providers. These competencies ensure the accuracy and reliability of provider data, which is crucial for seamless healthcare operations and regulatory compliance.
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 7 days ago
CareOregon rating
7.6
Based on 7 frontline employees who took The Breakroom Quiz
191st of 281 rated insurance
Job description
This position is responsible for enterprise leadership and strategic oversight of CareOregon's provider network data management, including provider data management and credentialing. Primary duties include strategic and operational leadership and planning, as well as resource, relationship, and people management. The Director ensures cohesive operations support, timely and accurate provider data configuration, credentialing oversight, and overall operational excellence across Medicaid and Medicare lines of business. This position is also accountable for ensuring all plan operations are compliant with OHA, CMS, and NCQA standards as applicable.
This position is required to be in the downtown Portland office 3x/week, We are looking for candidates in the Portland Metro area.
Estimated Hiring Range:
$155,430.00 - $189,970.00
Bonus Target:
Bonus - SIP Target, 10% Annual
Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.
Essential Responsibilities
Technical/Operational Leadership
- Provide strategic leadership for provider data management, including credentialing, and provider data.
- Develop and oversee execution of proactive strategic initiatives to ensure appropriate network development and wholistic provider data management.
- Ensure network practitioners are credentialed per plan policies.
- Ensure provider data systems are optimized to enable strategic network management, including accurate and timely claims processing and directory presentation.
- Effectively use business intelligence and data analytics to monitor network data accuracy, forecast system changes and overall plan data needs.
- Ensure compliance with federal, state, and contractual requirements.
- Identify and implement process improvement activities to improve department productivity.
- Ensure documented policies and procedures are established and maintained to ensure accurate, efficient, and compliant operations.
- Remain current with healthcare industry trends, best practices, and approaches to drive efficient and compliant network operations.
- Develop budgets in alignment with strategic planning.
- Ensure teams have sufficient resources to perform their work.
- Ensure budgets are monitored and managed effectively across areas of oversight.
- Approve resource allocations within budget, including people, finances, and timelines.
- Ensure strategic messages are regularly and effectively relayed to management team and staff; promote transparency.
- Collaborate with leaders across the organization in identifying integrated improvement strategies and ensuring meaningful integration.
- Direct team(s) and establish team direction and goals in alignment with the organizational mission, vision, and values.
- Identify work and staffing models; recruit, hire, and oversee a team to meet work needs, using an equity, diversity, and inclusion lens.
- Identify department priorities; ensure employees have information and resources to meet job expectations.
- Lead the development, communication, and oversight of team and individual goals; ensure goals, expectations, and standards are clearly understood by staff.
- Manage, coach, motivate, and guide employees; promote employee development.
- Evaluate employee performance and provide regular feedback to support success; recognize strong performance and address performance gaps and accountability (corrective action).
- Perform supervisory tasks in collaboration with Human Resources as needed.
- Organizational Responsibilities
- Perform work in alignment with the organization's mission, vision and values.
- Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
- Strive to meet annual business goals in support of the organization's strategic goals.
- Adhere to the organization's policies, procedures and other relevant compliance needs.
- Perform other duties as needed.
Organizational Responsibilities
- Perform work in alignment with the organization's mission, vision and values.
- Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
- Strive to meet annual business goals in support of the organization's strategic goals.
- Adhere to the organization's policies, procedures and other relevant compliance needs.
- Perform other duties as needed.
Experience and/or Education
Required
- Minimum 10 years' experience in health plan operations, provider network engagement and/or hospital or medical staff credentialing.
- Minimum 4 years' supervisory experience
- Management experience in a managed care organization or provider practice setting
- Provider relations experience
Knowledge, Skills and Abilities Required
Knowledge
- Strong understanding of Medicaid in a managed care environment
- Understanding of claims, provider directories and provider data
- Understanding of how to manage a production-oriented workforce
- Understanding of credentialing policies & practices
- Understanding of network regulatory reporting, including DSN and HSD tables
- Knowledge of federal Medicare regulations and state Medicaid rules (OARs)
Skills and Abilities
- Skilled in strategic thinking and executing strategy effectively; ability to think at an enterprise level
- Leadership effectiveness and ability to design and implement constructive change
- Strong people management skills, including the ability to coach and motivate teams
- Excellent critical thinking, analytical and problem-solving skills; ability to effectively analyze program goals and objectives to determine successes and opportunities for improvement
- Ability to effectively analyze program goals and objectives to determine successes and opportunities for improvement
- Ability to effectively convey business unit goals and plans ensuring integration into strategic plans and initiatives
- Highly skilled in resource management
- Ability to communicate effectively, both verbally and in writing, including strong presentation and change management skills
- Ability to influence and build consensus
- Ability to work in an environment with matrix reporting, diverse individuals and groups
- Ability to work effectively with diverse individuals and groups
- Ability to learn, focus, understand, and evaluate information and determine appropriate actions
- Ability to accept direction and feedback, as well as tolerate and manage stress
Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment
Travel: May include occasional required or optional travel outside of the workplace; the employee's personal vehicle, local transit or other means of transportation may be used.
Work Location: Office - 3 days/week
We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.
We are an equal opportunity employer
CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.
About CareOregon
Sourced by ZipRecruiter
Industry
Insurance services
Company size
1,001 - 5,000 Employees
Headquarters location
Portland, OR, US
Year founded
1994