Data Analyst

Job Title: Delegated Payer Enrollment Data Analyst

Position Summary

The Delegated Payer Enrollment Data Analyst is responsible for managing and analyzing provider enrollment data under delegated agreements with insurance payers. This role ensures compliance with payer-specific requirements, supports audit readiness, and maintains accurate provider rosters and reporting to facilitate timely reimbursement and operational efficiency.

Key Responsibilities

• Maintain and update delegated enrollment rosters in accordance with payer contracts and NCQA (National Committee of Quality Assurance) standards
• Analyze enrollment data to identify discrepancies between internal systems and payer records
• Collaborate with Medical Staff Office and Payer Enrollment Credentialing, IT, and revenue cycle teams to ensure data integrity across platforms
• Generate and submit reports to payers on a weekly, monthly, and quarterly basis as required
• Monitor compliance with delegated credentialing and enrollment agreements
• Support payer audits by preparing documentation and responding to data requests
• Identify and implement process improvements to streamline delegated enrollment workflows
• Act as a liaison between the organization and payer representatives to resolve enrollment issues
• Conduct large complex data analysis projects
• Develops methodology and processes for prioritization and scheduling of projects
• Maintain data confidentiality

Required Skills & Qualifications

• Bachelor s degree in Healthcare Administration, Business, Data Analytics, or related field
• 2 4 years of experience in provider enrollment, credentialing, or payer data analytics
• Strong understanding of delegated credentialing and enrollment processes
• Proficiency in Excel, SQL, and data visualization/reporting tools (e.g., Tableau, Power BI)
• Familiarity with enrollment systems (e.g., Credential Stream, PECOS, CAQH) and EHR platforms (e.g., Epic)
• Excellent attention to detail, organizational, and communication skills
• Ability to manage multiple priorities and meet tight deadlines

Preferred Qualifications

• Experience working with delegated payer agreements and NCQA audit standards
• Experience with payer portals (e.g., Availity, NaviNet)