Provider Data Analyst - WTCHP
About The Position
GDIT is seeking a detail-oriented and technically proficient Provider Data Analyst to support the World Trade Center (WTC) Health Program, a limited federal health program administered by the National Institute for Occupational Safety and Health, part of the Centers for Disease Control and Prevention in the U.S. Department of Health and Human Services. In this critical role, you will support the governance, quality, and operational effectiveness of provider data across the health plan ecosystem. This role focuses on analyzing provider data trends, identifying systemic issues, and improving the processes that support provider onboarding, credentialing, claims adjudication, and provider directory accuracy. Working closely with Provider Network Operations, Credentialing, Claims Administration, Member Services, and technology teams, the Provider Data Analyst evaluates provider data flows across systems and partners to ensure accuracy, consistency, and operational integrity. Unlike operational provider data roles that focus on record maintenance, this position is responsible for identifying patterns, improving data processes, and supporting strategic decision-making related to provider data management.
Requirements
- Bachelor’s degree in healthcare administration, data analytics, information systems, business, or a related field (or equivalent experience).
- 3–6 years of experience working with healthcare provider data, provider networks, credentialing operations, or health plan administration.
- Strong understanding of healthcare provider identifiers including NPIs, TINs, and service location structures.
- Experience analyzing operational healthcare data related to claims processing, credentialing, provider directories, or network participation.
- Strong analytical and problem-solving skills with the ability to identify systemic issues and trends.
- Advanced Excel skills including data analysis and reporting.
- Must be able to obtain and maintain MBI T2 Public Trust
Nice To Haves
- Experience working in a health plan, third-party administrator (TPA), or healthcare services organization.
- Familiarity with provider credentialing standards and verification processes.
- Exposure to provider data sources such as CAQH, credentialing vendors, or national provider databases.
- Experience working with data warehouses, SQL, or reporting tools such as Tableau or Power BI.
- Familiarity with healthcare accreditation or regulatory frameworks such as NCQA.
Responsibilities
- Provider Data Governance & Quality Monitor provider data quality across operational systems and identify systemic data issues affecting claims payment, network participation, or provider directories.
- Develop and maintain data validation rules and quality checks to ensure provider data integrity.
- Analyze provider data discrepancies and lead root cause investigations.
- Trend Analysis & Operational Insights Analyze trends in provider data errors, claims rejections, provider onboarding issues, and directory inaccuracies.
- Identify recurring operational problems and recommend process improvements.
- Develop dashboards and reports that provide visibility into provider data performance and quality metrics.
- Cross-System Data Coordination Evaluate how provider data flows between systems including provider network management, credentialing, claims processing, and directory platforms.
- Identify data gaps, transformation issues, and inconsistencies across systems and external data partners.
- Support system enhancements and process improvements related to provider data integration.
- Process Improvement Identify opportunities to streamline provider data intake, validation, and distribution processes.
- Partner with operational teams to implement improved workflows and controls.
- Support documentation and standardization of provider data management procedures.
- Operational Support Serve as a subject matter resource for provider data questions across operational teams.
- Support investigations of provider data issues impacting claims payment or provider participation.
- Collaborate with provider data operational teams to resolve complex data problems.
Benefits
- 401K with company match
- Comprehensive health and wellness packages
- Internal mobility team dedicated to helping you own your career
- Professional scientific growth opportunities, including journal subscriptions, conference attendance, and supporting publication journey
- Cutting-edge technology you can learn from
- Rest and recharge with paid vacation and holidays
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
