Provider Demographic Management Coordinator

Provider Demographic Management Coordinator (MEM009807) Position Summary The Provider Demographic Management Coordinator (PDM Coordinator) is responsible for generating health plan notifications including adds, changes, and terms. The coordinator catalogs and tracks all changes and ensures key updates are completed accordingly. Working directly with the Provider Demographic Specialist, the coordinator ensures the accuracy of network provider information listed on contracted health plan directories and websites, and assists in maintaining accurate and updated provider matrices and rosters on internal intranets and websites. Essential Functions and Responsibilities Familiar with regulatory standards including NCQA, ICE, DMHC, DHCS, CMS, and contracted health plans. Use pertinent data and facts to identify and solve a range of problems within area of expertise. Be at work and be on time. Follow company policies, procedures, and directives. Interact in a positive and constructive manner. Prioritize and multitask. Effectively establish and maintain working relationships, and prove able to continually follow up with appropriate parties to achieve optimal results. Track, update, and audit provider information in the database. Analyze problems by gathering all relevant information and develop appropriate solutions. Pay close attention to detail, accuracy, and completeness, and meet deadlines. Understand basic computer logic and conditional statements. Qualifications/Work Experience Minimum of 2-4 years of healthcare experience working in a managed care or information systems setting. Epic or equivalent managed care electronic medical record system and provider portal applications knowledge preferred. Experience with various healthcare industry regulatory agencies and requirements including CMS, NCQA, DMHC, ICE, DHCS, preferred. Strong communication skills, clear, tactful, and professional. Ability to work independently, remain on task, and prioritize to meet deadlines. Detail oriented with good organization and planning skills. Strong computer skills with broad knowledge of software packages; intermediate proficiency with MS Word, Excel, and Access. Willingness to accept responsibility and desire to learn new tasks. Working knowledge of data analysis, data presentation, and preparation of professional documents. Education/Licensure/Certification High school diploma required. Bachelor’s degree in Healthcare Analytics, Health Administration, or related major preferred. Comparable work experience in Provider Data Management or Provider Network Management considered. Primary Location United States-California-Fountain Valley #J-18808-Ljbffr MemorialCare Health System