Healthcare Data & Compliance Systems Analyst

Prominence-Health-Plan; Reno (NV); On-site; USD 65,000 - 90,000; Full time

Job summary

Prominence Health is seeking an Operations Analyst to provide design, development, implementation and support of reports and extracts, collaborating with leaders, subject matter experts and vendors to meet business needs. This role requires deep knowledge of claims processing and data integrity across multiple systems.

The position also plans and executes internal audits to test compliance with state and federal laws, analyzes regulatory requirements, and drives remediation of identified

Qualifications

• High school or equivalent required; associate degree preferred.
• 5 years health plan operations or health services experience preferred.
• Excellent interpersonal and organizational skills.
• Ability to communicate effectively in English, verbally and in writing.
• Strong knowledge of claims processing functions.
• Proficient with MS Office and project management tools.

Responsibilities

• Design, develop, implement and support reports and extracts.
• Gather and document reporting requirements with stakeholders.
• Audit compliance with state and federal laws; monitor remediation.
• Analyze regulatory requirements and apply them to operations.
• Coordinate with payers/clients on claims issues and data quality.

Skills

Health plan operations

Analytical skills

Communication skills

Project management

Attention to detail

Team collaboration

English communication

Education

High school or equivalent

Associate degree preferred

Tools

MS Office

MS Project

MS Visio

Job description

Prominence Health is seeking an Operations Analyst to provide design, development, implementation and support of reports and extracts, collaborating with leaders, subject matter experts and vendors to meet business needs. This role requires deep knowledge of claims processing and data integrity across multiple systems.

The position also plans and executes internal audits to test compliance with state and federal laws, analyzes regulatory requirements, and drives remediation of identified