Job Summary:
The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. Provider directory data experience preferred. This is a remote position.
Essential Functions:
- Participate as a member of Health Partner Lifecycle (HPLC) team to support existing provider data operations and new market implementations
- Perform disruption analysis activities for assigned markets
- Assimilate large quantities and/or complicated data into meaningful formats for tracking and status requirements
- Serve as Project Manager for select HPLC initiatives
- In conjunction with HPLC management team, develop Performance Improvement initiatives/corrective action plans to improve quality of provider data and network development
- In conjunction with HPLC management team, coordinate activities with regard to provider network data management and reporting
- Develop database structures and reports as needed
- Develop queries to aid in information retrieval, validation and updating of provider databases
- Review provider organizations and systems for development of analyses that support contract negotiation and provider recruitment processes
- Work with both internal and external partners to gain information for provider network reporting and analyses
- Coordinate and track all State files, hospital, physician and ancillary recruitment information
- Prepare NCQA documentation for assigned markets as appropriate
- Act as Subject Matter Expert for provider data and impacts to downstream processes
- Perform any other job duties as requested
Education and Experience:
- Bachelor’s degree or equivalent years of relevant work experience is required
- Minimum of three (3) years of data analysis or experience in a health care setting is required
- Experience with Cognizant Facets Provider application is required
- Managed care experience is preferred
- Project management experience is preferred
Competencies, Knowledge and Skills:
- Advanced Microsoft Excel, Access, and Word skills
- Knowledge and understanding of Facets data model
- Proficient in data analysis and use of analytics / reporting tools such as Power BI
- Demonstrates analytical and supporting technical skills to include SQL capabilities
- Experience with Visio and PowerPoint preferred
- Working knowledge of provider data repositories and directories preferred
- Ability to work independently and within a team environment
- Excellent written and verbal communication skills
- Ability to meet tight deadlines
- Extreme flexibility as projects and priorities shift
Licensure and Certification:
- None
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$61,500.00 - $98,400.00CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
SalaryOrganization Level Competencies
Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business