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Health Plan Data Analyst II (Health Plan Experience)

CareSource

Remote or Dayton, Ohio • Today

Full-time

USD 62,700.00 - 100,400.00 per year

Job Details

Skills

Interfaces
Performance Improvement
Corrective And Preventive Action
HPLC
Management
Data Management
Information Retrieval
Database
Negotiations
Network
Recruiting
Documentation
Health Care
Project Management
Microsoft Excel
Facets
Data Modeling
Data Analysis
Analytics
Reporting
Microsoft Power BI
Analytical Skill
SQL
Microsoft Visio
Microsoft PowerPoint
Communication
System Integration Testing
Training
Partnership
SD
Brand

Summary

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.

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:
$62,700.00 - $100,400.00
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 role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):
Salary

Organization Level Competencies

Fostering a Collaborative Workplace Culture
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 environment of belonging that welcomes and supports individuals of all backgrounds.
#LI-SD1

Brand=CareSource

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.

Dice Id: RTX11f1ed
Position Id: 5593ff358d3fe174ad61ff3b07b21cba
Posted 8 hours ago

Fitment

Dice Job Match Score™

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Remote or Dayton, Ohio

•

Today

Job Summary: The Health Plan Data Analyst is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. Additional responsibilities include analyzing data operations to support building new solutions and enhancing performance of existing solutions primarily in provider space and other areas as required. Essential Functions: Manage new HPLC initiatives from concept to implementation and provide statistics measuring

Full-time

USD 72,200.00 - 115,500.00 per year

Healthcare System Analyst – Payer Systems

Mason, Ohio

•

9d ago

Role: Healthcare System Analyst Payer Systems Location:2-Woodland Hills, CA/4-Mason, Ohio (Onsite) Job Type: FTE/Contract-W2 Job Description: 1 A technical system analyst with good understanding of the healthcare process flow Eligibility & Enrollment Provider contract pricing Claims adjudication Billing Appeals and Grievances 2 Technical understanding of Sql and Dot net full stack preferable 3 knowledge of Facets platform from a developer point of view i.e. data models, architecture,

Easy Apply

Contract

50 - 55

Healthcare System Analyst – Payer Systems

Mason, Ohio

•

3d ago

Job Description:Seeking aHealthcare System Analystwith strong knowledge of healthcare payer processes, includingEligibility & Enrollment, Provider Contract Pricing, Claims Adjudication, Billing, Appeals & Grievances.Strong hands-on experience withFacetsfrom a System Analyst/Developer perspective, includingdata models, architecture, benefits, claims, and end-to-end process flows.StrongSQLskills;.NET / Full-Stackdevelopment experience is preferred.Experience troubleshooting complexproduction issue

Easy Apply

Third Party, Contract

45 - 50

Medical Data Analyst II

Oklahoma

•

Today

Job Posting Title Medical Data Analyst II Agency 807 HEALTH CARE AUTHORITY Supervisory Organization Medical Services Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is blank. Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above. Estimated Appointment End Date (Continuous if Blank) Full/Part-Time Full time Job Type Regular Compensation $24.711538/hour Why You'll Love Working Here At t

Full-time

Compensation information provided in the description

Job Details

Skills

Interfaces
Performance Improvement
Corrective And Preventive Action
HPLC
Management
Data Management
Information Retrieval
Database
Negotiations
Network
Recruiting
Documentation
Health Care
Project Management
Microsoft Excel
Facets
Data Modeling
Data Analysis
Analytics
Reporting
Microsoft Power BI
Analytical Skill
SQL
Microsoft Visio
Microsoft PowerPoint
Communication
System Integration Testing
Training
Partnership
SD
Brand

Summary

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

Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business

Dice Id: RTX11f1ed
Position Id: 5593ff358d3fe174ad61ff3b07b21cba
Posted 8 hours ago

Fitment

Dice Job Match Score™

🔢 Crunching numbers...

Create job alert

Never miss an opportunity! Create an alert based on the job you applied for.

Remote or Dayton, Ohio

•

Today

Full-time

USD 72,200.00 - 115,500.00 per year

Healthcare System Analyst – Payer Systems

Mason, Ohio

•

9d ago

Easy Apply

Contract

50 - 55

Healthcare System Analyst – Payer Systems

Mason, Ohio

•

3d ago

Easy Apply

Third Party, Contract

45 - 50

Medical Data Analyst II

Oklahoma

•

Today

Full-time

Compensation information provided in the description

Health Plan Data Analyst II (Health Plan Experience)

Skills

Summary

Dice Job Match Score™

Similar Jobs

Health Plan Data Analyst II (Health Plan Experience)

Job Details

Skills

Summary

Dice Job Match Score™

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