Health Plan Data Analyst II (MCO/SQL a must) at CareSource

, Ohio, United States -

Full Time

Start Date

Immediate

Expiry Date

24 Jan, 26

Salary

98400.0

Posted On

26 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Data Analysis, SQL, Microsoft Excel, Microsoft Access, Microsoft Word, Power BI, Project Management, Cognizant Facets, Analytical Skills, Communication Skills, Provider Data Management, Performance Improvement, Database Development, Reporting, Team Collaboration, Flexibility

Industry

Insurance

Description

Job Summary: The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. Essential Functions: Participate as a member of Health Partner Lifecycle (HPLC) team to support existing provider data operations and new market implementations Perform disruption analysis activities for assigned markets Assimilate large quantities and/or complicated data into meaningful formats for tracking and status requirements Serve as Project Manager for select HPLC initiatives In conjunction with HPLC management team, develop Performance Improvement initiatives/corrective action plans to improve quality of provider data and network development In conjunction with HPLC management team, coordinate activities with regard to provider network data management and reporting Develop database structures and reports as needed Develop queries to aid in information retrieval, validation and updating of provider databases Review provider organizations and systems for development of analyses that support contract negotiation and provider recruitment processes Work with both internal and external partners to gain information for provider network reporting and analyses Coordinate and track all State files, hospital, physician and ancillary recruitment information Prepare NCQA documentation for assigned markets as appropriate Act as Subject Matter Expert for provider data and impacts to downstream processes Perform any other job duties as requested Education and Experience: Bachelor’s degree or equivalent years of relevant work experience is required Minimum of three (3) years of data analysis or experience in a health care setting is required Experience with Cognizant Facets Provider application is required Managed care experience is preferred Project management experience is preferred Competencies, Knowledge and Skills: Advanced Microsoft Excel, Access, and Word skills Knowledge and understanding of Facets data model Proficient in data analysis and use of analytics / reporting tools such as Power BI Demonstrates analytical and supporting technical skills to include SQL capabilities Experience with Visio and PowerPoint preferred Working knowledge of provider data repositories and directories preferred Ability to work independently and within a team environment Excellent written and verbal communication skills Ability to meet tight deadlines Extreme flexibility as projects and priorities shift Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $61,500.00 - $98,400.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-SD1 The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.

Responsibilities

The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking, and monitoring provider data across business functions. This role includes participating in the Health Partner Lifecycle team and developing performance improvement initiatives to enhance the quality of provider data.