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Posted: 03-Nov-24
Location: Los Angeles, California
Salary: Open
Categories:
Internal Number: 144136925
The Provider Data Management Senior Analyst will be responsible for processing, maintaining, and updating all aspects of the provider information database across all health plan products. You will:
- Ensure the accuracy and integrity of practitioner information within the company’s provider data systems
- Engage with both internal and external stakeholders through various communication channels to address inquiries related to practitioner information
- Collect, monitor, and study business data via EPIC, MD Staff (provider enrollment and claim system) or other repositories
- Create/pull reports that help mitigate regulatory risks, control costs, identify process breakdowns/issues, and ensure compliance with industry standards
Salary: $76,200-$158,800
- A Bachelor’s degree or equivalent experience
- 3-4 years of experience working in a Medicare Advantage health plan or Managed Care team - Claims, Provider Relations, Provider Contracting, Provider Network Management, highly desired
- Strong skills of MS Excel and SQL to create and run complex SQL queries, required
- Experience developing performance reports, required
- Strong knowledge and prior experience using Word, PowerPoint, Visio and data visualization tools, required
- Strong knowledge of the health care model, capitation and other managed care IPA and provider reimbursement methodologies
- Previous experience working as a Business Analyst or Project Manager, preferred
