The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. Demonstrated SQL experience is required.
Essential Functions
Participate as a member of Health Partner Lifecycle (HPLC) team on all expansion and provider network development activities
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
Managed care experience is preferred
Project management experience is preferred
Competencies, Knowledge And Skills
Proficient in data analysis and use of analytics / reporting tools such as Power BI
Advanced Microsoft Excel, Access, SQL and Word skills
Experience with Visio and PowerPoint preferred
Working knowledge of provider data repositories and directories preferred
Ability to work independently and within a team environment
Analytical and graphical presentation skills
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
$60,300.00 - $96,500.00 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. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type
Salary
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, including disability and veteran status. We are committed to a diverse and inclusive work environment.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Information Technology
Industries
Insurance
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