Enrollment Analyst II (SQL required)

Job Summary:

The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring enrollment data across business functions, systems and interfaces. 834 file experience a plus.

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:

CareSource 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 …