Address
Form of work
SalaryOverview:
Performs research and analysis to ensure accurate provider data. Primary responsibilities include data collection, analysis, engagement with provider community and reach out to ensure data integrity is maintained in system. Responsible for researching and coordinating with internal staff to ensure data is collected, maintained, and accurate. Also, acts as a liaison between Provider, Provider Network Management staff, Provider Configuration, Member Education and Engagement, External Provider Automation, Decision Support and other related departments to ensure data integrity of provider information and for process improvement and error resolution related to the provider data and provider directories
How you belong matters here.
Why Join Us
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses. Maximum Offer for this position is up to: USD $32.17/Hr. Compensation Disclaimer: The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.
Now hiring a Provider Network Data Specialist
Performs research and analysis to ensure accurate provider data. Primary responsibilities include data collection, analysis, engagement with provider community and reach out to ensure data integrity is maintained in system. Responsible for researching and coordinating with internal staff to ensure data is collected, maintained, and accurate. Also, acts as a liaison between Provider, Provider Network Management staff, Provider Configuration, Member Education and Engagement, External Provider Automation, Decision Support and other related departments to ensure data integrity of provider information and for process improvement and error resolution related to the provider data and provider directories
How you belong matters here.
We value our employees' differences and find strength in the diversity of our team and community.
At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.
Why Join Us
- Full Time - Exempt: Yes
- Job is based Rev Hugh Cooper Admin Center
- Work hours: Days
- Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.
High school diploma. A minimum of one year experience required in healthcare. Demonstrated ability to communicate effectively in person, via telephone and in writing. Requires strong organizational skills and the ability to work under pressure with minimal supervision. Microsoft Word, Access and Excel experience required.
Responsibilities: - References online policies and procedures to ensure accurate and consistent task completion.
- References online policies and procedures to ensure timelines and requirements are met.
- Plays an integral role in provider directory data validation process including review and verification of provider data. Researches and analyzes provider data to ensure that the online provider directories are accurate and meet the standards set for by regulators (i.e. NCQA, HSD, CMS).
- Enters data proficiently to ensure accuracy from provider applications into database, interpreting or adapting data to conform to defined data field uses.
- Sends out various provider notifications as well, assisting in developing new reporting and corresponding formats to ensure that data is current.
- Assists in developing and revising policies and procedures, criteria and audit tools to ensure compliance with national, federal and state regulatory agencies related to the provider directories.
- Responds effectively to high priority tasks while maintaining daily activities.
- Collaborates with multiple internal departments, vendors, and customers to ensure reliability, integrity and accuracy of provider data.
- Accountable for monitoring the business processes related to the accuracy of provider data.
- Must communicate and actively monitor the regulatory and legal obligations of accurate provider data, while understanding the impact to the health plan while initiating necessary activities to ensure compliance
- Ability to work on complex problems and provide guidance to create solutions that are innovative and more sophisticated in nature, achieving quality and work / process improvements.
All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.
Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.
Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.
About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.
Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.
Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.
