Overview
Job Summary
naviHealth recognizes the vital role providers play in enhancing our service delivery to members. A highly engaged provider network is critical to ensure members receive the right care at the right place for the right amount of time. The Provider Data Specialist works under the direction of the Manager, Network Reporting and Analytics to ensure data integrity and updates in provider databases for all markets. The position makes updates to provider databases using the Provider Data User Interface to update backend tables. The Provide Data Specialist also collaborates with IT resources on the creation and maintenance of naviHealth’s provider databases identifying data discrepancies and best practices.
Responsibilities
- Use the naviHealth user interface for MPD to make updates as requested by naviHealth colleagues and customers.
- Ensure the data integrity and updates to the provider databases.
- Analyze and verify accuracy of provider data received from external sources and link to a provider record in naviHealth’s system.
- Work with Provider Data Analysts and Provider Data Specialist to correct provider records as needed.
- Review data for deficiencies or errors, correct any incompatibilities, and check output.
- Work with analytics staff to correct duplicate provider records.
- Ensure accurate, timely maintenance of critical provider information in nH coordinate and provider databases.
- Synchronize data among multiple databases and application of business rules as they apply to each database.
- Validate the data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting and network management.
- Perform other duties and responsibilities as required, assigned, or requested.
Qualifications
- Associate degree or higher required; in lieu of a degree, 2+ years of relevant experience may be considered
- 2 – 3 years of related experience required
- Experienced in managed care, health plan operations in provider contracting, customer service, or provider relations
- Ability to independently plan, organize and prioritize work
- Ability to build and foster relationships inside and outside the organization
- Excellent written and oral communications skills
- Must be able to plan, prioritize and handle multiple tasks/demands simultaneously
- Proficient with Microsoft Office applications including Word, Excel, and PowerPoint
- Strong analytical and problem-solving ability required
About naviHealth
naviHealth is improving the healthcare experience for seniors to live more fulfilling lives. For nearly a decade, naviHealth has been a trusted partner for the nation’s top health plans, health systems, and at-risk physician groups navigating the shift from volume to value. Powered by a predictive technology and decision support platform that provides clinicians and care teams with evidence-based protocols, naviHealth’s high-touch, proven care model fully supports patients from pre-acute through to the home. With naviHealth, patients can enjoy more days at home, and healthcare providers and health plans can significantly reduce costs specific to unnecessary care and readmissions. For more information about naviHealth, visit navihealth.com.
Our Purpose
Improving the healthcare experience for seniors to live a more fulfilling life
Our Values
Rooted in respect
Guided by purpose
Devoted to service
Energized by impact
The above statements are intended to describe the general nature and level of work performed by colleagues assigned to this job. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications. naviHealth reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.
naviHealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other protected status under applicable laws and will not be discriminated against based on disability.
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