Provider Data Management Senior Analyst

General Information

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Work Location: Los Angeles, USA Onsite or Remote Flexible Hybrid Work Schedule Monday-Friday, 8:00am-5:00pm PST Posted Date 10/03/2024 Salary Range: $76200 - 158800 Annually Employment Type 2 - Staff: Career Duration Indefinite Job # 19644

Primary Duties and Responsibilities

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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

Job Qualifications

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• 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