Provider Network Data Integrity Analyst, Health Plan
Job Description:
• Responsible for the accuracy, completeness, and required regulatory filings of the Health Plan’s provider network.
• Serves as a resource for strategic planning, compliance, and network analysis.
• Completes network adequacy reviews, in collaboration with the Health Plan's Business Intelligence Department representatives.
• Performs analyses and audits to identify gaps in current provider networks.
• Coordinates required regulatory provider network submissions to ensure HP meets contractual obligations.
• Maintains accurate data in HP Provider Directory.
Requirements:
• Bachelor’s Degree in business administration, finance, healthcare related field, computer science, or analytics.
• Successful completion of a post-secondary medical terminology course preferred.
• Three years’ experience in a medical group practice, health insurance or Health Maintenance Organization (HMO) environment.
• Demonstrated knowledge of data manipulation and analytical analysis.
• Proficiency with Microsoft Office suite to include products, Excel and Access.
• Understanding of geoaccess coding, provider credentialing, and medical terminology preferred.
Benefits:
• Health insurance
• Retirement plans
• Paid time off
• Responsible for the accuracy, completeness, and required regulatory filings of the Health Plan’s provider network.
• Serves as a resource for strategic planning, compliance, and network analysis.
• Completes network adequacy reviews, in collaboration with the Health Plan's Business Intelligence Department representatives.
• Performs analyses and audits to identify gaps in current provider networks.
• Coordinates required regulatory provider network submissions to ensure HP meets contractual obligations.
• Maintains accurate data in HP Provider Directory.
Requirements:
• Bachelor’s Degree in business administration, finance, healthcare related field, computer science, or analytics.
• Successful completion of a post-secondary medical terminology course preferred.
• Three years’ experience in a medical group practice, health insurance or Health Maintenance Organization (HMO) environment.
• Demonstrated knowledge of data manipulation and analytical analysis.
• Proficiency with Microsoft Office suite to include products, Excel and Access.
• Understanding of geoaccess coding, provider credentialing, and medical terminology preferred.
Benefits:
• Health insurance
• Retirement plans
• Paid time off