Source Job

• Monitor provider data quality and identify systemic issues.
• Develop and maintain data validation rules and quality checks.
• Analyze provider data discrepancies and lead root cause investigations.

Massachusetts General is a healthcare organization. They seem to value professional growth and provide opportunities for career development.

• Collaborate with implementation teams and external customers to ensure data integrity and interface validation for symplr software solutions.
• Analyze and manage patient healthcare data for consistency and accuracy while configuring system software during implementation projects.
• Leverage analytical, technical, and communication skills to define processes for clinical data management and assist customers in achieving their organizational goals.

Symplr is revolutionizing healthcare operations with a first-of-its-kind platform that drives effective, efficient, and connected workflows, increasing operational benefits and scaling clinical, financial, and quality outcomes. We are a remote-first company with employees across the United States, India, and the Netherlands.

• Execute credentialing and enrollment workflows for new providers.
• Maintain accurate provider and practice data in credentialing database.
• Complete Medicare revalidations, Medicaid recredentialing, and commercial recredentialing per payer schedules.

Integrated Dermatology is a leading national dermatology practice that acquires and partners with dermatology practices across the United States. The culture at ID is filled with hard-working, dynamic individuals who come together to ensure the success of our partner dermatologists.

• Manage complex provider roster creation, submission, and record reconciliation.
• Oversee resolution of moderate-scope issues by prioritizing tasks.
• Serve as main contact for roster inquiries, collaborating with internal teams and external payers.

Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. Founded in 2014, they are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.

• Manage the credentialing and re-credentialing processes for physicians, nurses, and allied health professionals.
• Verify licenses, certifications, education, training, and work history to ensure providers are fully qualified.
• Maintain accurate and complete credentialing files, ensuring all staff are cleared before providing care.

Curana Health focuses on improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, with over 1,000 clinicians serving 200,000+ seniors across 32 states.

• Manage and maintain accurate provider credentialing files and profiles.
• Support Clinical Operations including Provider communications.
• Coordinate full-cycle credentialing, re-credentialing, and insurance contracting.

SimpliFed is focused on providing maternal health services. The company appears to be a startup with a focus on innovation and improving women’s health.

• Provides support to the Network Provider Operations department with daily operations, project initiatives, system updates, special projects, and all regulatory reporting and analysis.
• Audits departmental operations with a focus on data integrity, improving accuracy, and identifying training opportunities for department.
• Leads system upgrades and implementations for the department, and provide technical support as needed.

Elderplan and HomeFirst are Medicare and Medicaid managed care health plans that are expanding services in response to patients' and members' needs. They are part of MJHS, a supportive community committed to excellence, respect, and providing high-quality, personalized health care services.

• Establish and monitor performance metrics to measure the reliability and latency of payer data feeds.
• Serve as the primary point of escalation for high-priority payer data issues, coordinating with various teams.
• Oversee the documentation and submission processes for clinical data extracts to ensure audit readiness.

Aledade empowers independent primary care practices to deliver better patient care and thrive in value-based care. As the largest network of independent primary care in the country, they focus on creating value-based contracts, strengthening care continuity, and aligning incentives to ensure physicians are paid for keeping patients healthy.

• Responsible for establishing and maintaining positive relationships with various providers.
• Drives provider engagement and communication, supporting network development.
• Manages provider performance, shares data, and supports the implementation of quality initiatives.

CommonSpirit Health has over 700 care sites across the U.S., offering services from clinics and hospitals to home-based and virtual care. They are committed to building healthy communities and advocating for those who are poor and vulnerable.

• Evaluate facility credentialing applications for accuracy and completeness.
• Engage with facilities to clarify credentialing-related questions and obtain missing information.
• Update and maintain credentialing software systems with necessary facility information.

Curana Health is dedicated to radically improving the health, happiness, and dignity of older adults. They are a national leader in value-based care, serving 200,000+ seniors in 1,500+ communities across 32 states, with a team of more than 1,000 clinicians and professionals.

• Ensure timely resolution and completion of payer enrollment.
• Streamline processes and workflows for the onboarding department.
• Work with internal and external stakeholders to resolve complex provider enrollment issues.

Privia Health collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology.

• Manages a queue of incoming documents to create new clients, update existing clients, and send interdepartmental tasks in the CRM system.
• Requires frequent use of Provider Portals and multiple internal databases and document retrieval systems.
• Operates within a service level agreement managing speed to start entry while observing various agency specific handling procedures maintaining the highest level of accuracy for billing and compliance purposes.

Mom's Meals is a company focused on providing nutrition solutions. They appear to value community support based on the job descriptions.

• Gather, clarify, and document detailed technical requirements, including data mapping, transformation logic, and schema definitions.
• Verify that delivered data products meet business needs through rigorous testing and SQL-based validation.
• Maintain a prioritized and groomed product backlog; translate stakeholder requests into actionable user stories for the engineering team.

Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care. The Privia Platform consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers