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- Encounter Analytics and Direct Payment are part of the California Provider Analytics & Reporting team, focusing on provider performance reporting to ensure compliance, operational efficiency, and strategic insights.
- We are a remote-only team based in California, meeting weekly to discuss reporting requests and deliver enterprise-level reporting support to the broader market.
- This role is a backfill to support ongoing initiatives.
Job Summary
Story Behind the Need
- Encounter Analytics and Direct Payment are part of the California Provider Analytics & Reporting team, focusing on provider performance reporting to ensure compliance, operational efficiency, and strategic insights.
- We are a remote-only team based in California, meeting weekly to discuss reporting requests and deliver enterprise-level reporting support to the broader market.
- This role is a backfill to support ongoing initiatives.
Location: Sacramento, California
Job Type: Contract
Salary: $38 - 48 per hour
Work Hours: 8am to 5pm
Education: Bachelor's degree
Responsibilities
- Extract data from claims, enrollment, encounter, and payment systems
- Clean and transform raw data for accuracy and usability
- Integrate data from multiple sources
- Monitor encounter data for operational inefficiencies and risk adjustment
- Analyze encounter data for compliance with regulations
- Measure provider performance using various metrics
- Build dashboards and reports with Power BI
- Present insights to inform strategy and policy
- Ensure regulatory compliance of reports
- Provide reconciliation reports to stakeholders
- Prepare data submissions for regulatory agencies
- Meet reporting deadlines and quality standards
- Stay updated on policy changes
- Collaborate with IT to optimize data systems
- Partner with Provider Engagement teams to evaluate reporting effectiveness
- Analyze member and provider data to identify care gaps
- Recommend operational improvements based on data
- Test and validate new analytics tools
- Respond to data requests from stakeholders
- Investigate anomalies in encounter submissions
- Learn about legislative impacts on health analytics
- Report on project milestones and performance
Qualifications
- Bachelor's in math, statistics, information systems, computer science, or related field
- Minimum 4 years of relevant experience
- Proficiency in SQL and Python essential
- Experience with SAS Enterprise Guide, Teradata, Oracle, Snowflake SQL
- Strong communication skills and ability to work independently and collaboratively
Skills
Top 3 hard skills:
- SQL
- Python (data wrangling and management)
- Excel
Additional Information
We are an equal opportunity employer and accommodate applicants with disabilities. Pay is based on various factors, and a comprehensive benefits package is offered.