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Provider Data Specialist

Versant Health

Provider Data Specialist

Baltimore, MD
Full Time
Paid
  • Responsibilities

    Job Description

    PROVIDER DATA SPECIALIST

    SEE how you can MAKE A DIFFERENCE! Be part of an innovative company that cares about its associates and helps members enjoy the wonders of sight through healthy eyes and vision.

    Versant Health provides vision care to 37 million members nationwide! To ensure your continued success we provide opportunities for advancement and development. Our associates remain engaged through a comprehensive compensation and benefits package which includes health and dental insurance, tuition reimbursements, 401(k) with company match, pet insurance and FREE vision insurance for you and your family.

    SCOPE AND PURPOSE OF POSITION

    Responsible for formatting and delivering appropriate provider network data for use in RFP responses, sales & marketing support, health plan client requirements and Compliance filings.

    ESSENTIAL FUNCTIONS

    • Process and track requests for provider network such as accessibility reports, disruption and adequacy reports, network size comparisons etc. from the RFP team, Sales VPs and RSMs, managed care clients, Compliance and other internal and external customers in an accurate and timely fashion
    • Publish and post directories for all commercial networks in all states on a monthly basis and geographically specific directories as requested
    • Process and track requests for Netminder Reports from the RFP team, Sales VPs and RSMs and other internal and external customers in an accurate and timely fashion
    • Process and track requests for disruption reports for both commercial and health plan in an accurate and timely fashion

    EDUCATION & EXPERIENCE

    • High school graduate, Bachelor's Degree preferred
    • Previous experience in running a wide variety of Geo Access and/or Quest Analytics reports is preferred
    • Two years of experience in the health care or health insurance field is required

    HIPAA & SECURITY REQUIREMENTS

    All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company’s Privacy & Security Training Program

     

    WE TAKE PRIDE IN OUR RECRUITING PROCESS AND FOLLOW A MERIT-BASED EMPLOYEE RECRUITMENT PRACTICE WITH EXTENSIVE SCREENING STEPS. WE WILL NEVER REQUEST MONEY FROM CANDIDATES WHO SEEK EMPLOYMENT WITH US AND WILL NEVER ASK FOR ANY PAYMENT AS PART OF THE RECRUITMENT PROCESS.

     

    WE PROVIDE EQUAL EMPLOYMENT OPPORTUNITIES (EEO) TO ALL ASSOCIATES AND APPLICANTS FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGIOUS BELIEFS, AGE, SEX (INCLUDING PREGNANCY), SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION (INCLUDING TRANSGENDER STATUS), NATIONAL ORIGIN, ANCESTRY, STATUS AS A PROTECTED VETERAN OR DISABLED VETERAN, PHYSICAL OR MENTAL DISABILITY OR HISTORY OF DISABILITY, GENETIC INFORMATION, MARITAL STATUS, OR ANY AND ALL OTHER CATEGORIES PROTECTED BY UNDER APPLICABLE FEDERAL, STATE OR LOCAL LAW.

     

    This policy extends to all associates and to all aspects of the employment relationship. Any associate who violates this policy will be subject to disciplinary action up to and including termination

    Company Description

    Versant Health bringing you Davis Vision and Superior Vision is a leading provider of vision and eye health solutions. We offer a full spectrum of services in the vision care marketplace. Our mission is very real to our members: we help them enjoy the wonders of sight through healthy eyes and vision. What you do as a Versant Health Associate matters. 37 million Americans count on us to provide access to annual eye exams and corrective eyewear. We are here to change the face of vision care, and together we will make this happen.