Health Plan Reporting Analyst

24 Hour Home Care - Corporate Division•El Segundo, CA

9d•$70,000 - $82,000•Hybrid

About The Position

The Health Plan Reporting Analyst manages the preparation, validation, and submission of medical and operational reports required by health plan contracts and regulatory requirements. This role ensures reporting deliverables are accurate, complete, and submitted on time while coordinating across teams to resolve data discrepancies and maintain compliance with contractual requirements.

Requirements

Bachelor’s degree in Healthcare Administration, Health Information Management, Business, Analytics, or a related field; equivalent relevant experience may be considered.
2+ years of experience in healthcare reporting, managed care reporting, regulatory reporting, data operations, or a related function preferred.
Advanced proficiency in Microsoft Excel, including formulas, lookups, filtering, data validation, and data reconciliation.
Experience working with secure portals, SFTP, structured reporting templates, and recurring submission deadlines preferred.
Knowledge of HIPAA and appropriate handling of protected health information preferred.
Healthcare and managed care reporting
Data validation and reconciliation
Microsoft Excel
Reporting calendar and deadline management
Quality assurance and exception tracking
Process documentation
Cross-functional coordination
Written and verbal communication
Confidentiality and compliance
Attention to detail and organization

Responsibilities

Compile and submit recurring health plan reports, including Referral Tracking Files (RTFs), authorization files, capacity reports, and other required deliverables.
Prepare reports according to health plan-specific templates, file formats, reporting periods, naming conventions, and submission requirements.
Validate and reconcile authorization, referral, service, member, and other reporting data to ensure accuracy and completeness before submission.
Maintain reporting calendars, trackers, submission confirmations, health plan requirements, templates, contacts, and supporting documentation.
Monitor changes to health plan reporting requirements and coordinate resolution of missing, conflicting, or rejected data and files.
Partner with Payor Relations, Operations, Compliance, Finance, and IT data owners to resolve reporting exceptions and communicate deadlines, risks, and corrective actions.
Maintain reporting procedures, checklists, data definitions, and work instructions while identifying opportunities to improve data quality and reporting efficiency.