Provider Data Analyst I

Moda Health•Portland, OR

2d•Remote

About The Position

Moda Health, founded in 1955, is a healthcare company focused on building a better future for healthcare by offering outstanding coverage to its members, compassionate support to its community, and comprehensive benefits to its employees. Moda values diversity and inclusion in its workplace and business practices. The Provider Data Analyst I role supports contract negotiations with medical providers by conducting analysis using claims data and other sources to model the impact of various contract terms. This is a full-time, work-from-home position.

Requirements

Bachelor’s degree required.
Strong statistical, analytical, and problem-solving skills.
Experience with healthcare billing or claims data.
Intermediate Microsoft Excel skills and proficiency with all Microsoft Office products.
Ability to communicate effectively both verbally and in writing.
Ability to work well under pressure and with shifting priorities.
Ability to work collaboratively as part of a team.
Maintain confidentiality and project a professional business image.
A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work.
Must be comfortable being on camera for virtual training and meetings.

Nice To Haves

Master’s in healthcare administration or business administration is preferred.
Experience in the health insurance, healthcare provider or public health industry is preferred.
Experience with data analysis tools such as SAS, SQL, decision support systems, business intelligence tools and/or Microsoft Access is preferred.

Responsibilities

Provide analytic support to determine bottom line impacts for proposed medical provider contract terms.
Evaluate the impact of new reimbursement methodologies on current Provider Billing practices.
Audit contract renewals to ensure reimbursement terms were interpreted and implemented correctly.
Update database that holds provider contract terms and analysis results.
Assess network functionality and potential for increased efficiency.
Build custom reports for contract negotiators to help achieve desired contract term agreements.
Perform ad hoc market research, competitive analysis, and other business analyses, as needed.
Other duties as assigned.