Dignity Health Management Services Organization (Dignity Health MSO) aims to establish a system-wide integrated physician-centric, full-service management service organization structure. They offer various management and business services, leveraging economies of scale and leading efforts in developing Dignity Health’s Medicaid population health care management pathways.
Responsible for the maintenance of relevant provider data for use in network development and contracting, provider relations, marketing & communications, contracting, and more.
This role will also work with other network development teams to support provider data management across the CommonSpirit enterprise, including contracting and credentialing teams, to complete requests and support network operations.
Collect, validate, and maintain provider data to support marketing, provider relations, network contracting, credentialing across all lines of business.
Supervise a team of appeals and grievances coordinators; develop/implement strategies to improve team performance and efficiency.
Receive, document, and manage member and provider appeals and grievances in accordance with Dignity Health MSOs policies and standards. Prepare and present reports on appeals and grievances activity.
Maintain detailed and accurate records of all appeals and grievances, including documentation of investigations, outcomes, and communications.