Greater New York City Area (NY, NJ, CT) or other approved areas Remote (Country)

Healthfirst is hiring a Provider Data Operations Specialist

About the Role

This role is responsible for managing provider data across multiple systems, ensuring data accuracy, consistency, and compliance with internal and external standards. The specialist collaborates with cross-functional teams to resolve data discrepancies and support operational workflows.

Responsibilities

  • Maintain provider data in corporate systems to ensure completeness and accuracy
  • Verify provider credentials and supporting documentation
  • Process provider enrollment and revalidation requests
  • Respond to internal and external data inquiries
  • Support provider directory accuracy and compliance initiatives
  • Identify and resolve data inconsistencies across platforms
  • Collaborate with IT and vendor teams on data integration
  • Ensure adherence to regulatory and accreditation requirements
  • Generate reports on provider data metrics and quality
  • Participate in audits and data validation projects
  • Update provider information in response to changes
  • Facilitate provider data transfers during system migrations
  • Monitor data workflows for efficiency and accuracy
  • Escalate complex issues to appropriate stakeholders
  • Maintain confidentiality of sensitive provider information
  • Assist in onboarding new providers into the network
  • Track and report on data processing timelines
  • Support provider portal functionality and updates
  • Coordinate with provider relations teams on data issues
  • Implement process improvements to enhance data quality
  • Ensure timely communication with provider offices
  • Follow established protocols for data entry and validation
  • Assist in testing new system enhancements
  • Maintain documentation for data procedures
  • Support network adequacy reporting requirements

Compensation

Competitive salary and benefits package

Work Arrangement

Hybrid work model

Team

Collaborative team environment within provider data management

Why Join Us

  • Opportunity to work in a mission-driven organization focused on community health
  • Supportive culture that values employee development and work-life balance

What We Offer

  • Comprehensive medical, dental, and vision coverage
  • Retirement savings plan with company match
  • Paid time off and holidays
  • Professional growth and training programs
  • Employee assistance and wellness resources

Not available

Required Skills
ExcelCRM SoftwareData AnalysisData EntryProcess ImprovementQuality AssuranceProject ManagementHealthcare Operations
About company
Healthfirst
Healthfirst is New York’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable healthcare. As part of the community for nearly 30 years, Healthfirst’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well-being. This value-based care model is the foundation of the company’s sustained growth in one of the most dynamic markets in the country. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then Healthfirst is for you.Click here to navigate back to the career site!
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Job Details
Category other
Posted 6 months ago