Provider Data Quality & Systems Analyst II

Horizon Blue Cross Blue Shield of New Jersey; Newark (NJ); On-site; USD 63,000 - 84,000; Full time

Benefits offered by this job

Comprehensive health benefits

Retirement Plans

Generous PTO

Incentive Plans

Wellness Programs

Paid Volunteer Time Off

Tuition Reimbursement

Job summary

Horizon Blue Cross Blue Shield of New Jersey is seeking a data management professional to support Network Data Management and all departments utilizing provider data, including screening provider loading and coordinating related procedures.

The role handles important projects with high attention, analyzes data integrity, develops system specs, tests changes, and contributes to improving data quality across government programs and related systems.

Qualifications

• High School Diploma or GED required.
• Minimum of 5 years in provider data management in healthcare/insurance.
• Knowledge of provider systems, claims processing, and data integration.

Responsibilities

• Direct the Provider File Area activities to ensure accurate, complete, timely maintenance of Government Programs provider data.
• Resolve provider data errors by identifying cause, proposing improvements, and documenting best practices.
• Develop specifications for system enhancements and ensure integration with current and planned systems.
• Create specifications and user testing criteria with proper documentation to ensure data quality.
• Evaluate and improve current procedures to boost efficiency and controls.
• Handle important or sensitive projects requiring high attention.
• Produce departmental reporting for quality, production, including vendor audits.
• Represent the department on workgroups and committees.

Skills

Attention to detail

Analytical abilities

Effective communication

Ability to work independently

Organize and prioritize work

Cross-functional collaboration

Education

High School Diploma/GED

Tools

MS Office (Word, Excel, PowerPoint)

Outlook

Windows-based environment

Job description

Horizon Blue Cross Blue Shield of New Jersey is seeking a data management professional to support Network Data Management and all departments utilizing provider data, including screening provider loading and coordinating related procedures.

The role handles important projects with high attention, analyzes data integrity, develops system specs, tests changes, and contributes to improving data quality across government programs and related systems.