Provider Data Analyst

UnitedHealth Group•Cypress, CA

6d•$24 - $43•Remote

About The Position

The Provider Data Analyst is a key member of the Provider Data Management team, responsible for maintaining the accuracy, integrity, and quality of provider data across enterprise systems. This role serves as the subject matter expert for provider demographic, ensuring that provider records are complete, accurate, and compliant with internal standards and regulatory requirements. The Provider Data Management team is responsible for managing the full lifecycle of provider data, including provider onboarding, demographic updates, contract maintenance, roster management, terminations, audits, and data quality initiatives. The Provider Data Analyst works closely with Credentialing, Claims, Customer Service, Provider Relations, Finance, Network Management, and external providers to ensure provider information is accurately reflected throughout all systems and downstream processes. This position plays a critical role in supporting provider network operations by researching and resolving provider data discrepancies, conducting data validation and quality assurance reviews, maintaining provider databases, processing provider updates and terminations, and supporting claims resolution activities resulting from provider data issues. The role also contributes to reporting, regulatory compliance, system enhancements, and process improvement initiatives designed to improve data accuracy and operational efficiency. Through proactive data management, analysis, and collaboration with cross-functional partners, the Provider Data Analyst helps ensure the integrity of the provider network, supports accurate claims processing and provider payments, and contributes to a positive provider experience.

Requirements

2+ years of managed care, healthcare administration, medical insurance, or provider operations experience
1+ years of experience in provider data management, claims, customer service, credentialing, or provider support
6+ months of experience working with provider rosters, demographic data
6+ months of experience in researching and resolving complex provider or claims-related issues
Advanced level of verbal and written communication skills with professional telephone etiquette
Intermediate level of proficiency with Microsoft Office applications, including Excel and Word

Nice To Haves

Ability to work independently while managing multiple priorities and meeting deadlines
Strong organizational, analytical, and problem-solving skills

Responsibilities

Maintain accurate and compliant provider demographic, contract, and location data across enterprise systems
Process provider additions, updates, disclosures, roster changes, and terminations through Salesforce and other internal applications
Generate, validate, and distribute provider rosters, demographic verification reports, and client/regulatory reporting
Perform data audits, quality reviews, and provider demographic verification to ensure data integrity and compliance
Research and resolve provider data issues impacting claims, payments, and customer service, including provider verification requests and claims reprocessing
Investigate and resolve provider payment issues, including returned checks, billing address discrepancies, and levy requests
Collaborate with Claims, Credentialing, Customer Service, Finance, and Network Management teams to support provider data accuracy and operational effectiveness
Develop reports, support process improvement, and system enhancements
Support administrative functions, workload coordination, and shared team responsibilities to ensure timely completion of provider data activities