Health Plan Data Analyst II (Health Plan Experience)
About The Position
The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. This role participates as a member of the Health Partner Lifecycle (HPLC) team to support existing provider data operations and new market implementations. The analyst will perform disruption analysis, assimilate large quantities of data into meaningful formats, and serve as Project Manager for select HPLC initiatives. They will also develop performance improvement initiatives, coordinate activities related to provider network data management and reporting, and develop database structures and reports. Additionally, the role involves developing queries for information retrieval, validation, and updating of provider databases, reviewing provider organizations and systems for analyses supporting contract negotiation and provider recruitment, and coordinating/tracking State files and recruitment information. The analyst will prepare NCQA documentation and act as a Subject Matter Expert for provider data. This position requires a Bachelor’s degree or equivalent work experience, a minimum of three years of data analysis or healthcare experience, and specific experience with the Cognizant Facets Provider application. Managed care and project management experience are preferred.
Requirements
- 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
- 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
- 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
Nice To Haves
- Managed care experience is preferred
- Project management experience is preferred
- Experience with Visio and PowerPoint preferred
- Working knowledge of provider data repositories and directories preferred
Responsibilities
- 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
Benefits
- Substantial and comprehensive total rewards package
- May qualify for a bonus tied to company and individual performance
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
