Sr. Provider Data Analyst - Indianapolis, United States - Professional Management Enterprises

Description

Seeking a

Sr. Provider Data Analyst

is to analyze complex business problems and issues using data from internal and external sources to provide insight to decision-makers.

Identifies and interprets trends and patterns in datasets to locate influences. Fully remote. Work scheduled is M-F, 8a-5p EST.


Summary:
Constructs forecasts, recommendations and strategic/tactical plans based on business data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements.

Collaborates with health plan and shared services to modify or tailor existing analysis or reports to meet their specific needs.

Essential Responsibilities:
Responsible for accurate and timely identification of critical information on configuration and claims databases.

Oversees operational and claims systems and application of business rules.

Validates data to be housed on databases and ensures adherence to business and system requirements of health plan and other business requirements.

Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements.

Oversees coding, updating, and maintaining benefit plans, provider contracts, fee schedules and various system tables.

Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.

Required Education:
Bachelor's Degree or equivalent combination of education and experience

Required Experience:

2-5 years of relevant work experience.

Experience with MS Office applications required, especially strong Excel skill. Skill with SQL or SAS.

Experience with data management and analysis preferred.

Must have strong quantitative and analytical skills.

Experience in health care industry desired.
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