Provider Data Services Specialist

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary
The Provider Data Services Specialist is responsible for conducting proactive outreach to provider offices to validate provider demographic information, network participation status, and directory information for providers contracted with Medicaid and Dual Special Needs Plans (D-SNP). Outreach results will be documented within QuickBase and/or Salesforce and shared with Provider Data Services, Compliance, and Medicaid business partners for analysis and follow-up.

The Specialist will support provider directory accuracy initiatives by collecting and analyzing validation results to measure directory data quality, which will identify trends and root causes of inaccuracies.  Through these efforts, the role contributes to improving the member experience and ensuring accurate provider information is available to members.

In addition, this position will support ad hoc provider outreach initiatives related to Medicaid and Dual provider directory validation, data quality projects, regulatory requirements, and special business initiatives as needed.

Key Responsibilities

• Conduct outbound provider office outreach to validate directory demographic information, provider participation, and accessibility data.
• Accurately document outreach findings in QuickBase, Salesforce, and other designated systems.
• Support Medicaid and Dual provider directory monitoring and validation activities.
• Participate in special projects and ad hoc outreach initiatives related to provider data quality and directory validation.
• Maintain productivity, quality, and accuracy standards while managing a high volume of provider outreach activities.
  
  Required Qualifications
  

• 1-2 years experience in healthcare administration
• Strong Oral communcaiton skills
  
  Preferred Qualifications
  
• Previous experience working with provider demographic data
• Previous experience working within QuickBase
• Previous experience in a call center environment
  
  Education
  High school diploma or equivalent required

Anticipated Weekly Hours

Time Type

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

Additional details about available benefits are provided during the application process and on Benefits Moments.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.