Healthcare Data & Compliance Analyst

Talentify; Reno (NV); Vor Ort; USD 75.000 - 95.000; Vollzeit

Benefits dieser Stelle

Loan Forgiveness Program

Competitive compensation

Medical, Dental, Vision and Rx Plans

401(K) with company match

Zusammenfassung

Prominence Health, a value-based care organization, seeks an Operations Analyst to design and support reporting, audits, and regulatory reviews. You will collaborate with leaders and vendors to gather needs and verify data integrity across systems.

The role requires knowledge of claims processing, fee schedules, and contracts, with focus on ensuring compliance and remediation of deficiencies while supporting audits.

Qualifikationen

• High school or equivalent required; associate degree preferred.
• Experience in health plan operations or health services desirable.
• Strong organizational and communication skills with cross-functional teams.
• Understanding of claims processing functions and regulatory concepts.

Aufgaben

• Design, development, implementation and support of reports and extracts.
• Gather and document reporting requirements with business leaders and vendors.
• Conduct independent internal audits to test compliance with state and federal laws.
• Analyze regulatory requirements and apply them to operations during reviews.
• Monitor remediation progress of identified deficiencies.
• Coordinate with multiple payers/clients on claims issues and data integrity.

Kenntnisse

Analytical thinking

Communication skills

Project management

Team collaboration

English proficiency

Ausbildung

High school or equivalent

Associate degree preferred

Tools

MS Office

MS Project

MS Visio

Jobbeschreibung

Prominence Health, a value-based care organization, seeks an Operations Analyst to design and support reporting, audits, and regulatory reviews. You will collaborate with leaders and vendors to gather needs and verify data integrity across systems.

The role requires knowledge of claims processing, fee schedules, and contracts, with focus on ensuring compliance and remediation of deficiencies while supporting audits.