Provider Data & Operations Analyst II

CareSource; Kentucky; Hybrid; USD 63,000 - 100,000; Full time

Job summary

CareSource is seeking a Provider Operations Analyst II to transform large, complex data into actionable insights for tracking and status reporting.

You will develop queries, support multiple provider-data workflows, and serve as SME for operations initiatives across Claims, Credentialing, Directories, and Pended Claims. A strong data-analysis background and experience with Facets are preferred.

Qualifications

• Bachelor's Degree or equivalent years of relevant work experience required.
• Minimum three (3) years of health care or managed care experience required.
• Experience with provider data, data governance or related processes preferred.

Responsibilities

• Develop queries to identify provider data issues and assist in remediation plans.
• Provide analysis and oversight for provider data workflows and processes.
• Act as SME/BA/Data Analyst for Provider Operations on initiatives and projects.
• Work cross functionally with Claims, Configuration, Market Reps, and Provider Operations to integrate workflows.
• Identify, develop, and implement reporting and business processes to ensure data quality and regulatory compliance.

Skills

SQL

Data analysis

Excel

PowerPoint

Communication

Cross-functional collaboration

Education

Bachelor's Degree or equivalent

Tools

Facets

SQL

Access

Job description

CareSource is seeking a Provider Operations Analyst II to transform large, complex data into actionable insights for tracking and status reporting.

You will develop queries, support multiple provider-data workflows, and serve as SME for operations initiatives across Claims, Credentialing, Directories, and Pended Claims. A strong data-analysis background and experience with Facets are preferred.