Provider Network Data Associate II

Company: L.A. Care Health Plan
Location: Los Angeles
Posted on: February 3, 2025

Job Description:

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:

• Paid Time Off (PTO)
• Tuition Reimbursement
• Retirement Plans
• Medical, Dental and Vision
• Wellness Program
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Keywords: L.A. Care Health Plan, Highland , Provider Network Data Associate II, Other , Los Angeles, California