Healthcare Sr. Provider Data Analyst (60468)
Sr. Provider Data Analyst to analyze complex business problems and issues using data from internal and external sources to provide insight to decision-makers. MUST be an experienced user of Quest Analytics and management of GEO. Fully remote. Work scheduled is M-F, 8a-5p EST.
Summary...
Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with health plan and shared services to modify or tailor existing analysis or reports to meet their specific needs.
Essential Responsibilities:
Responsible for accurate and timely identification of critical information on configuration and claims databases.
Oversees operational and claims systems and application of business rules.
Validates data to be housed on databases and ensures adherence to business and system requirements of health plan and other business requirements.
Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements.
Oversees coding, updating, and maintaining benefit plans, provider contracts, fee schedules and various system tables.
Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.
Required Education:
Bachelors Degree or equivalent combination of education and experience
Required Experience:
2-5 years of relevant work experience.
1-3 years formal training in Business Analysis and/or Systems Analysis
1-3 years Quest Analytics and management of GEO
Summary...
Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with health plan and shared services to modify or tailor existing analysis or reports to meet their specific needs.
Essential Responsibilities:
Responsible for accurate and timely identification of critical information on configuration and claims databases.
Oversees operational and claims systems and application of business rules.
Validates data to be housed on databases and ensures adherence to business and system requirements of health plan and other business requirements.
Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements.
Oversees coding, updating, and maintaining benefit plans, provider contracts, fee schedules and various system tables.
Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.
Required Education:
Bachelors Degree or equivalent combination of education and experience
Required Experience:
2-5 years of relevant work experience.
1-3 years formal training in Business Analysis and/or Systems Analysis
1-3 years Quest Analytics and management of GEO