Healthcare Reporting Analyst I

Cleveland Clinic

2d•Remote

About The Position

The Healthcare Reporting Analyst I prepares, analyzes, and reports financial and revenue cycle management information through standard and ad hoc reports that support enterprise needs. The role audits and validates provider roster data from contracted commercial health plans, checking accuracy against contract requirements, value-based initiatives, and service level requirements. It compares health plan information with internal provider databases, investigates discrepancies in provider demographics, credentialing, enrollment status, practice locations, and provider assignments, and collaborates with health plans to resolve data quality issues. The analyst monitors and trends roster errors, validates provider attribution for value-based care and risk contracts, and supports new health plan implementations through roster audits and quality assurance reviews. Using advanced Excel skills, the analyst works with large datasets, develops reporting requirements, validates reporting outputs, and partners with database developers and the Network Data & Reporting team on data quality initiatives. The role may use AI tools such as Copilot and ChatGPT to improve reporting efficiency and documentation, and investigates provider data issues that may affect claims processing, reimbursement, authorizations, network participation, and patient access. There is no direct patient interaction. The position is remote, and candidates must reside in Ohio, Florida, or Nevada.

Requirements

Bachelor’s degree in Accounting, Finance, Business, or a related field; or an associate’s degree and two years of experience; or a high school diploma/GED and four years of experience.
Ability to complete basic analytical, consultative, and information support through analysis and report preparation.
Awareness of key performance indicators, cash flow analysis, product line analysis, and proposal development.
Must reside in Ohio, Florida, or Nevada.

Nice To Haves

One year of Accounting, Finance, Healthcare, Investment Banking, or Management Consulting experience.
Certified Public Accountant (CPA) or Certified Management Accountant (CMA) certification.
Familiarity with SQL coding or backend system relationships.
Experience with Microsoft Copilot, ChatGPT, Epic's Coco, or Snowflake-related AI capabilities.
Advanced Excel proficiency, including conditional formatting, pivot tables, formulas, and VLOOKUP.
Credentialing experience.
Professional experience working with provider enrollment, credentialing, provider rosters, provider demographics, or provider directory data within a healthcare organization or health plan.

Responsibilities

Prepare, analyze, and communicate key financial information and support management and staff with financial reporting and related issues.
Audit and validate provider roster data from contracted commercial health plans and compare it with internal provider databases.
Identify discrepancies in provider demographics, credentialing, enrollment status, practice locations, and provider assignments, and work with health plans to resolve data quality issues.
Monitor and trend roster errors and validate provider attribution for value-based care and risk contracts.
Support new health plan implementations through roster audits and quality assurance reviews.
Analyze large datasets, develop reporting requirements, and validate reporting outputs using advanced Excel skills.
Partner with database developers and the Network Data & Reporting team on data quality initiatives.
Investigate provider data issues that could affect claims processing, reimbursement, authorizations, network participation, and patient access to care.
Assist with budget preparation, financial planning, and budget reviews for compliance and opportunities.
Serve as a consultant to management at all levels, providing decision support for initiatives, policies, and procedures.
Complete special projects and duties, including research, forecasting, and conflict resolution.
Perform other duties as assigned.