Provider Data Coordinator

Job Title: Provider Data CoordinatorIndustry: HealthcareLocation: Fountain Valley, CAShift: 40 hours per week, 8 hours per day, 5 days per week. Note: this req is internally labeled Part Time despite this full time hour schedule, the same discrepancy pattern seen on prior MemorialCare reqs — worth confirming with the client.Client OverviewYou'd be working in the provider network department of a large nonprofit health system, keeping physician and provider information accurate and up to date across contracted health plan directories and internal systems.Top 3 SkillsProvider data management and roster maintenanceHealthcare regulatory compliance (NCQA, CMS, DMHC, DHCS)Health plan directory verification and reportingWhat You'll DoMaintain departmental matrixes and provider rostersVerify health plan directories and websites for accurate provider informationAssist other departments with health plan related questions and requestsSupport timely submission of health plan adds, changes, terms, and periodic reportsCatalog and track all changes, ensuring key updates are completed on scheduleGenerate health plan notifications for provider adds, changes, and terms, including supporting documentsSupport the maintenance of ACO rosters and ensure daily changes are updated in internal systemsHelp ensure plan partner changes are accurately updated across databasesCreate monthly rosters for multiple contracted networksUse data and facts to identify and solve problems within your area of expertiseWhat We Need From YouHigh school diploma required2 to 4 years of healthcare experience in a managed care or information systems settingFamiliarity with regulatory standards such as NCQA, DMHC, DHCS, and CMSStrong computer skills, including intermediate proficiency with common office software and database toolsDetail oriented, able to prioritize and meet deadlines across multiple stakeholdersPreferred / BonusExperience in Provider Data Management or Provider Network ManagementExperience with various healthcare regulatory agencies and requirementsEpic or equivalent managed care EMR and provider portal experienceBachelor's degree in Healthcare Analytics, Health Administration, or a related fieldAbout ElevaitElevait Solutions was founded by veterans who believe that how you treat people is the only thing that actually matters in this industry. We're a team that stays in your corner before, during, and after placement. We show up for the communities we work in, we tell you the truth, and we work hard to make sure every placement is a good fit for both sides. If that sounds like the kind of team you want behind you, we'd like to talk.Elevait is a certified Service Disabled Veteran Owned Small Business, has over 100,000 LinkedIn followers, and was named a top company for hiring veterans by U.S. Veterans Magazine. We'd encourage you to check us out directly on our website and LinkedIn rather than just taking a recruiter's word for it.Buzzwordsprovider, data, roster, network, compliance, regulatory, directory, verification, reporting, managementTop 3 LinkedIn Job TitlesProvider Data CoordinatorProvider Network CoordinatorProvider Demographic CoordinatorInternal Market Recap (Client: MemorialCare, Fountain Valley, CA)Pay PositioningThis req's Max Rate of $61.35/hr sits well above typical market pay for this role. National Provider Data Coordinator pay averages $26.73 to $33/hr ($55,607 to $68,998/yr), with California specific data running somewhat higher at around $37/hr ($76,105/yr), and Provider Network Coordinator nationally averages $27.99/hr. Given this same pattern (a high "Max Rate") has now appeared on multiple MemorialCare reqs using this VMS platform, this figure likely reflects a bill rate rather than a confirmed candidate wage. A realistic candidate facing rate would likely fall in the $27 to $37/hr range, and should be confirmed directly with the client before quoting anything to candidates.Competitive LandscapeCalOptima, Regal Medical Group, UC Irvine Health, Kaiser Permanente Orange County, Hoag Hospital, St. Jude Medical Center, Providence St. Joseph Hospital Orange, Casa Colina Hospital and Centers for Healthcare.Contractor to FTE TrendsThis req's Reason for Requisition is listed as FMLA/LOA, meaning this is backfilling a leave of absence, not new headcount. Frame it to candidates as a defined term coverage assignment rather than assuming a permanent path.Selling Points and Watch OutsMemorialCare is a well regarded, large nonprofit health system in Orange County, a strong resume line even though the name can't be shared with candidates in writingThis req is backfilling an FMLA/leave of absence, not a new position, so the assignment is genuinely temporary and tied to another employee's return dateThis req is internally labeled Part Time despite a 40 hour weekly, 5 day schedule in the same record, the same discrepancy pattern seen on prior MemorialCare reqs. Worth confirming with the client before quoting hours to a candidateNo clear candidate facing pay rate has been confirmed yet. The $61.35 figure on file looks like a bill rate, not a wage, so nothing should be quoted to candidates until that's clarifiedCandidate ProfileA healthcare administrative or data management professional with 2 to 4 years of managed care or information systems experience, comfortable with provider data verification, regulatory compliance work, and maintaining accurate rosters across multiple health plan networks.Sourcing ChannelsTarget current provider data and network coordinators at the competitor health systems and managed care organizations listed above, healthcare administrative job boards across Orange County, and candidates with NCQA/CMS/DMHC regulatory exposure.LinkedIn Location CoverageFountain Valley sits in central Orange County, part of the greater Los Angeles and Orange County metro, connected via I-405 and CA-22 to the surrounding Orange County cities.Location Type Est. drive time from Fountain Valley LinkedIn recognition confidence Los Angeles Metro Area 30 to 40 min (borderline) High Fountain Valley City Anchor Medium Huntington Beach Suburb 10 to 15 min High Costa Mesa Suburb 10 to 15 min High Westminster Suburb 10 to 15 min High Garden Grove Suburb 10 to 15 min High Santa Ana City 15 to 20 min High Newport Beach City 15 to 20 min High Irvine City 20 to 25 min High Anaheim City 20 to 25 min High Long Beach City 20 to 25 min HighBest metro area optionLos AngelesBest city/suburb optionsHuntington BeachCosta MesaSanta AnaBroad LinkedIn location coverage listLos AngelesFountain ValleyHuntington BeachCosta MesaWestminsterGarden GroveSanta AnaNewport BeachIrvineAnaheimLong BeachLean LinkedIn location coverage listFountain ValleyHuntington BeachCosta MesaSanta AnaBoolean Search String("provider data" OR "provider network" OR "provider demographic") AND (roster OR "provider data" OR NCQA OR CMS OR DMHC OR DHCS OR directory) AND (Epic OR ACO OR credentialing OR "managed care")