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Provider Network Data Associate II - Los Angeles California
Company: L.A. Care Health Plan
Location: Los Angeles, California
Posted On: 01/30/2025
Provider Network Data Associate IIJob Category: Provider RelationsDepartment: Provider Data ManagementLocation: Los Angeles, CA, US, 90017Position Type: Full TimeRequisition ID: 11419Salary Range: $46,800.00 (Min.) - $52,597.00 (Mid.) - $62,270.00 (Max.)Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan, serving more than 2 million members.Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents.The Provider Network Data Associate II supports the L.A. Care Health Plan's various product lines. Responsibilities include monitoring and evaluating the movement of providers, maintaining an up-to-date Provider Database, coordinating member re-assignment, assisting in claims processing, and entering contracts into the Manage Health Care (MHC) System.Duties Provide support to the Provider Relations Department, including monitoring provider movement across Plan Partners and Participating Physician Groups (PPGs). Assist Member Services to resolve provider discrepancies and coordinate member re-assignment upon termination of a Primary Care Provider (PCP). Coordinate the entry of provider contracts into the MHC and MPD Database, ensuring accuracy and integrity of the Provider Database. Participate in Healthcare Effectiveness Data and Information Set (HEDIS) reporting efforts. Ensure all PPGs receive their Eligibility list within 5 days. Perform other duties as assigned.Education RequiredRequired: At least 6 months of healthcare work-related experience, understanding of provider data requirements and claims processing.SkillsStrong analytical skills.Physical RequirementsLightAdditional InformationSalary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.L.A. Care offers a wide range of benefits including: |
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