Health Plan Data Analyst II: Provider Insights & Optimization

CareSource; Dayton (KY); Hybrid; USD 63,000 - 100,000; Full time

Job summary

CareSource seeks a Health Plan Data Analyst II to extract, analyze, and report on provider data across multiple business functions and interfaces. You will support the Health Partner Lifecycle (HPLC) team and assist with market implementations and data quality initiatives.

The role requires at least a bachelor’s degree and 3+ years in data analysis within healthcare, with experience in Cognizant Facets and SQL. You will develop databases, run queries, and help drive contract negotiation support.

Qualifications

• 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.

Responsibilities

• Support provider data operations and market implementations with HPLC team.
• Perform disruption analysis 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.
• Develop Performance Improvement initiatives/corrective action plans to improve quality of provider data and network development.
• 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

Skills

Advanced Excel, Access, Word

SQL capabilities

Analytical thinking

Education

Bachelor’s degree or equivalent years of relevant work experience

Tools

Cognizant Facets Provider

Power BI

Visio

PowerPoint

Job description

CareSource seeks a Health Plan Data Analyst II to extract, analyze, and report on provider data across multiple business functions and interfaces. You will support the Health Partner Lifecycle (HPLC) team and assist with market implementations and data quality initiatives.

The role requires at least a bachelor’s degree and 3+ years in data analysis within healthcare, with experience in Cognizant Facets and SQL. You will develop databases, run queries, and help drive contract negotiation support.