7,731 provider data jobs at 3,392 companies in United States
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Provider Data Specialist
Brighton, Massachusetts, United States
$70k-$80k/yrHybridFull Time
Brighton Marine: Healthcare and housing services for veterans and their families.
2+ YOEMaintain and validate provider and facility data, ensure regulatory and directory compliance, support credentialing and claims teams, and generate data quality reports. Requires 2+ years provider data or related healthcare experience.
Microsoft Excel, Microsoft Office, Facets, QNXT, HealthRules, CAQH, NPPES, PECOS
Hill Physicians: Provides managed healthcare services through a large physician network.
Bachelor's degree or equivalent, experience with data validation and analysis, project coordination, proficiency in Microsoft Office/Excel, Salesforce experience preferred, strong communication and attention to detail.
Salesforce, Microsoft Office Suite, Microsoft Excel, Tableau
CenteneNYSE: CNC: Provides government-sponsored and commercial healthcare insurance programs and services.
3+ YOE1+ MgmtBachelor's in business/healthcare, 3+ years healthcare experience, 1+ year management experience, provider directory and provider data knowledge, project and reporting experience.
CVS HealthNYSE: CVS: Provides retail pharmacy, health insurance, and pharmacy benefit management services.
1+ YOEAt least 1 year healthcare or data-entry experience, high school diploma/GED, proficiency with Microsoft Teams/Excel/Word; SQL and QXNT preferred; strong attention to detail and problem-solving.
Microsoft Teams, Microsoft Excel, Microsoft Word, SQL, QXNT
CareOregon: Provides managed health insurance and services for low-income populations.
10+ YOE4+ Mgmt10+ years in health plan operations or credentialing, experience with Medicaid/Medicare compliance, strategic leadership, people and budget management, and provider data systems oversight.
Point32Health: Provides health insurance plans and medical well-being services.
5+ YOE5+ years managed care experience, program development and team leadership, subject-matter knowledge of provider directory regulations, advanced Excel skills, strong communication, and ability to oversee vendor/platform performance.
Thyme Care: Provides technology-enabled oncology care navigation and patient support.
Deep experience with healthcare data (EHR/claims/prior auth), analytics, data modeling, dbt and SQL expertise, working knowledge of Python or R, and familiarity with BI tools such as Looker.
PacificSource: Provides health insurance plans and healthcare administration services.
2+ YOEMaintain and audit provider data, process additions/terminations/changes, verify licensure and payer eligibility, support compliance and provider inquiries. Requires accurate data entry and collaboration with internal teams.
Analyst, Data Management (National Provider Contracts)
Long Beach or United States
$54k-$118k/yrRemoteFull Time
Molina HealthcareNYSE: MOH: Provides managed health insurance through government-sponsored benefit programs.
5+ YOE5+ years data management experience, BA/BS required, proficiency with SQL, EMR systems, MS Office, Python/Perl/SAS, experience with data profiling, migration, and healthcare provider data.
Microsoft Office, SQL, Python, PERL, SAS, Salesforce, Data cubes, QNXT, Med Insight, CMS
AltaMed: Provides comprehensive healthcare services to underserved Southern California communities.
2+ YOEMaintain and audit provider directory data, validate demographic and credentialing details, resolve discrepancies, and conduct outreach; bachelor’s with 2 years or HS diploma with 6 years in provider data/network/credentialing; CMS compliance experience.
Phoenix or Alaska or Arkansas or Arizona or Colorado or Florida or Hawaii or Iowa or Idaho or Illinois or Kansas or Louisiana or Maryland or Minnesota or Missouri or Montana or Nebraska or Nevada or New Mexico or North Carolina or North Dakota or Oklahoma or Oregon or South Carolina or South Dakota or Tennessee or Texas or Utah or Virginia or District of Columbia or Washington or Wisconsin or Wyoming
$78k-$92k/yrRemoteFull Time
TriWest Healthcare Alliance: Manages healthcare programs for veterans and military families.
3+ YOEBachelor's degree or equivalent, 3+ years healthcare/data analysis, knowledge of CMS coding and provider reimbursement, strong Excel and SQL skills, experience with data visualization and government claims preferred.
Microsoft Excel, SQL, SQL Reporting Services (SRS), Tableau, Power BI
Versant Health: Manages vision care benefits and provider networks.
Formatting and delivering provider network data, producing network and disruption reports, performing data and statistical analysis, maintaining Zelis and competitor data, proficiency with Excel/Access and Business Objects, and HIPAA compliance.
Microsoft Excel, Microsoft Access, Business Objects, Quest Analytics, Zelis
UnitedHealth GroupNYSE: UNH: Provides health insurance and technology-enabled health care services.
12+ YOE7+ Mgmt12+ years in digital product or data platform leadership, 7+ years leading large teams; experience with data platforms, APIs, integrations, regulated industries, and stakeholder influence.
Hively: Provides child care resources and mental health services to families.
BA/BS in social services or related field, prior provider payments or family support experience, strong communication, data entry, confidentiality handling, and technical skills (Microsoft Office, Zendesk, Google Suite).
Microsoft Office, Zendesk, Google Suite, Microsoft Excel, Google Sheets, Excel
Oscar HealthNYSE: OSCR: Provides tech-enabled health insurance plans and telemedicine services.
10+ YOE5+ Mgmt10+ years in operations/health insurance/data/consulting, 5+ years leading operational teams and provider data/network operations, program management and process improvement experience required.
SQL, Lean Six Sigma, Master Data Management (MDM), AI, RPA
CareSource: Provides public health insurance plans and care management services.
2+ YOEBachelor's degree or equivalent experience, 2+ years in healthcare reimbursement/provider contracting or claims analysis, proficiency in SQL and Python, experience with Power BI/Tableau, and strong analytical and communication skills.