Senior Analyst, Provider Data Management -SQL/QNXT - Remote

Molina Healthcare; Macon (GA); Remote; USD 70,000 - 90,000; Full time

Job summary

A healthcare service provider in Macon, Georgia, seeks a skilled professional to maintain critical provider information across databases. The role requires strong business analysis skills, proficiency in data analysis tools such as Excel or SQL, and exceptional communication abilities. Preferred applicants will have 5-7 years of relevant experience. Competitive benefits are offered.

Benefits

Competitive benefits package

Qualifications

• 5-7 years of business analysis experience.
• Proficiency in data analysis tools.
• Excellent communication and interpersonal skills.

Responsibilities

• Maintain critical provider information on claims databases.
• Develop and maintain documentation for assigned responsibilities.
• Assist in planning coordination for claim payment system upgrades.

Skills

Data analysis

Communication skills

Documentation

SOP development

Stakeholder interaction

Education

Bachelor's Degree in business administration or healthcare management

Tools

Excel

SQL

Job description

JOB DESCRIPTION

Job Summary

Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases. Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business rules as they apply to each database. Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.

KNOWLEDGE/SKILLS/ABILITIES

• Generates data to support continuous quality of provider data and developing SOPs and/or BRDs.
• Develops and maintains documentation and guidelines for all assigned areas of responsibility.
• Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality.
• Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans.
• Participates in the implementation and conversion of new and existing health plans.

JOB QUALIFICATIONS

Required Education

• Bachelor's Degree in business administration, healthcare management, or a related field; or equivalent combination of education and experience

Required Experience

• 5-7 years of business analysis experience
• Proficiency in data analysis tools and techniques, such as Excel or SQL
• Excellent communication, presentation, and interpersonal skills, with the ability to interact effectively with stakeholders at all levels

Preferred Experience

• 7-9 years of business analysis experience

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.