Senior Provider Network Data Analyst — Remote MI

RPMGlobal; Southfield (MI); Hybrid; USD 90,000 - 120,000; Full time

Job summary

RPMGlobal is seeking a Senior Provider Network Operations Data Analyst to join our fully remote team serving Michigan residents. The role acts as a subject matter expert, trains new hires, and ensures accurate processing of provider data, rosters, and related files.

Responsibilities include supporting analysts with complex questions, maintaining data quality, and collaborating with cross-functional teams. Facets experience and healthcare data skills are valued.

Qualifications

• Bachelor's degree or equivalent combination of education and relevant work experience.
• 3 to 5 years of experience in data analysis, healthcare operations, provider network operations, provider data operations, or a related field.
• Experience with provider enrollment and changes.
• Experience developing reports and analyzing complex datasets.
• Managed care or healthcare experience preferred
• Knowledge of Facets or similar healthcare administration platforms.

Responsibilities

• Serve as a go-to subject matter expert for Provider Network Operations processes, including incoming provider data, provider enrollment file completion, and Facets updates.
• Train new hires and provide ongoing education to analysts to ensure the team remains knowledgeable, consistent, and prepared as business requirements, systems, reporting needs, or processes change.
• Process and oversee complex provider data files, large rosters, provider enrollments, and related updates while ensuring information is entered accurately and maintained appropriately in Facets and other applicable systems.
• Monitor analyst workloads, review processing quality, audit analyst work, identify coaching opportunities, and provide guidance to support accuracy, productivity, and adherence to established procedures.
• Develop new ideas and recommend process improvements that strengthen data quality, streamline enrollment and roster workflows, and improve team effectiveness.
• Ensure provider data is accurate, complete, and compliant with internal standards, business rules, and reporting requirements; research and resolve discrepancies in a timely and thorough manner.
• Maintain strong working relationships with provider groups, internal business partners, and cross-functional teams to support provider enrollment, data integrity, issue resolution, and operational needs.
• User Acceptance Testing (UAT)/Client Review & audit (fee schedule concentration), reviews requests prior to initial submission to EO, and claims post-production
• Capitation reconciliations, building queries, and comparing membership
• Internal business report development; engagement with regulatory reporting
• BAM/claim reporting submission and analysis, depending on complexity
• Perform additional duties and special projects as assigned.

Skills

Analytical skills

Data analysis

Problem-solving

Excel

Communication skills

Training

Team collaboration

Attention to detail

Prioritization

Project management

Education

Bachelor's degree

Tools

Facets

Job description

RPMGlobal is seeking a Senior Provider Network Operations Data Analyst to join our fully remote team serving Michigan residents. The role acts as a subject matter expert, trains new hires, and ensures accurate processing of provider data, rosters, and related files.

Responsibilities include supporting analysts with complex questions, maintaining data quality, and collaborating with cross-functional teams. Facets experience and healthcare data skills are valued.