• Healthcare Data Management Specialist

    Dignity Health (Redlands, CA)


    Responsibilities

    ***This position is remote, but will be expected to work PST business hours.

    Position Summary:

    The Clinical Integration Network (CIN) and Accountable Care Organization (ACO) programs are clinically integrated physician networks sponsored by Dignity Health (DH). Similar to the CIN/ACO Networks, the Greater Sacramento Service Area (GSSA) Network, is a partnership between Mercy Medical Group, Woodland Clinic and Hill Physicians Medical Group. In addition, in order to fill service gaps in a CIN/ACO Network, a complementary network of ancillary providers is maintained in each region. This role focuses on data management to support population health analytics and the effective operation of physician networks under Dignity Health MSO.

     

    The Data Management Specialist is an employee of Dignity Health Management Service Organization (MSO). Under the direction of the CIN/ACO Manager, this individual:

     

    - provides data management support services to Dignity Health’s CIN/ACO Networks, Performance Insight, Employer Relations, and Valued Based Operations

     

    - gathers, maintains, and reconciles accurate healthcare data within the Salesforce platform, utilizing multiple data sources including 3rd party payors

     

    - generates reports on physician networks to support performance monitoring and improvement

     

    - conducts review of network adequacy and capabilities

     

    - maintains and transmits fee schedules as necessary to third-party administrators (TPAs) and other stakeholders

     

    - provides customer support services to Dignity Health CIN/ACO Networks

     

    - supports population health analytics by ensuring data quality and accessibility

    Qualifications

    Minimum Qualifications:

    - Minimum 3 years’ experience in provider relations, provider credentialing, provider database maintenance and reporting, provider contracting and/or network development in a health care or managed care setting required

     

    - High school diploma or equivalent required

     

    - Demonstrated skills in the areas of written and verbal communication, judgment, and problem-solving

     

    - Strong proficiency in Microsoft Office products required

     

    - This position requires a highly motivated person with exceptional customer service, relationship management and interpersonal skills

     

    - Attention to detail

     

    - Capable of independent thinking

     

    - Ability to perform in a team environment

    Preferred Qualifications:

    - Bachelor’s Degree in Business, Finance, Health Care Management, Economics or equivalent preferred.

     

    - Experience with Protected Health Information (PHI) preferred.

     

    - Strong understanding of HIPAA regulations, medical terminology, and data integrity principles preferred.

     

    - Strong proficiency in Google Workspace preferred.

     

    Overview

     

    The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

     

    Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

     

    One Community. One Mission. One California (https://youtu.be/RrPuiSnALJY?si=pvQgPZ6ZWZM60TPV)

    Pay Range

    $23.00 - $31.38 /hour

     

    We are an equal opportunity/affirmative action employer.