Senior Provider Performance Analyst

Amerihealth Caritas•,

3d•Remote

About The Position

The Senior Provider Performance Analyst develops, maintains, and administers provider incentive models. This remote role may be performed from any location within the United States, with availability required during Eastern Standard Time hours. A reliable high-speed internet connection is required, with minimum speeds of 50 Mbps download and 5 Mbps upload. Associates residing in states where reimbursement is required by contract, law, or regulation may submit eligible expenses for reimbursement.

Requirements

Bachelor’s degree in a relevant field.
3 to 5 years of enterprise or business analytics experience within the managed care or healthcare industry.
Minimum of 5+ years of experience in data analysis, reporting, or claims processing.
Strong written communication skills, including experience producing value-based care collateral such as program descriptions, contracting documents, and proposals.
Demonstrated experience developing value-based programs and provider incentive models, including Episode of Care and Bundled Payment models.
Solid understanding of statutory reporting requirements.
Advanced proficiency in Microsoft Office Suite.
Proficiency in at least one reporting or data analysis tool, such as SAS Enterprise Guide, SQL, or MS Access.

Responsibilities

Develop, maintain, and execute provider incentive models across the enterprise.
Ensure data accuracy, integrity, consistency, and completeness across internal and external sources, including Oracle data warehouses.
Identify data-related issues, perform root cause analyses, and collaborate with end-users and IT teams to resolve problems.
Define and maintain business rules for the use and interpretation of reporting data fields.
Identify, validate, and manage data sources to support enterprise reporting needs.
Create, update, and maintain documentation—including data dictionaries, business rules, database structures, and reporting procedures—for all lines of business.
Develop and execute testing processes for data and reporting solutions, and track and facilitate resolution of data-related issues.
Support training and education initiatives related to data comprehension, reporting, and provider performance tracking.
Assist in designing and refining models and metrics that measure provider performance.
Collaborate with associates across organizational levels and with external clients and vendors.