Health Plan Data Analyst II (SQL required)
Mississippi WFH, United States
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:
$55,350.00 - $88,560.00CareSource 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. 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
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
ApplyJob Profile
Comprehensive rewards package Comprehensive total rewards package Flexibility Flexible work environment General office environment Inclusive environment
Tasks- Contract negotiation
- Coordinate provider network data management
- Data Analysis
- Develop database structures and reports
- Extract and analyze provider data
- Provider recruitment
- Serve as project manager
Access Analysis Analytical Analytics Certification Communication Contract Negotiation Data analysis Documentation Excel Facets Managed Care Management Microsoft Access Microsoft Excel Microsoft Word NCQA Negotiation Network Operations Organization Performance Improvement Power BI PowerPoint Project Management Provider data management Provider network Provider Recruitment Reporting SQL Training Visio Word
Experience3 years
EducationBachelor's degree Business Equivalent Health Care
Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9