PR:$38/hr- $40/hr

About the Role:

• The Sr. Provider Data Analyst is responsible for analyzing complex business problems and issues using data from internal and external sources to provide insight to decision-makers.
• The role involves identifying trends and patterns in datasets, constructing forecasts, recommendations, and strategic/tactical plans based on business data and market knowledge.
• The Analyst will collaborate with health plan and shared services to modify or tailor existing analysis or reports to meet specific needs.

Responsibilities: -

• Analyze and interpret data to determine appropriate configuration changes
• Interpret specific state and/or federal benefits, contracts, and additional business requirements and convert them to configuration parameters 
• Oversee coding, updating, and maintaining benefit plans, provider contracts, fee schedules, and various system tables through the user interface
• Research and resolve claim/encounter issues, pended claims, and update systems as necessary
• Prioritize work to meet deadlines and user community needs
• Provide analytical, problem-solving foundation including definition and documentation, specifications
• Identify changes to existing business processes and opportunities for process developments and improvements
• Analyze business workflow and system needs for conversions and migrations to ensure regulations are met
• Prepare high-level user documentation and training materials as needed
• Identify opportunities for continuous improvement, standardization, and reduction of rework across health plan and shared services
• Monitor, coordinate, and communicate the strategic objectives of health plan across shared services to optimize performance/results 
• Aggregate and assist with the analysis of health plan and shared service data

Education Qualification: -

• Bachelor’s Degree or equivalent combination of education and experience
• 1-3 years formal training in Business Analysis and/or Systems Analysis

Required Skills: -

• 2-5 years of experience in a similar role
• Strong analytical skills 
• Ability to prioritize work and meet deadlines 
• Knowledge of health plan operations and claims databases
• Experience in data analysis and interpretation 
• Excellent problem-solving skills
• Ability to identify opportunities for process improvements
• Strong communication and collaboration skills
• Proficiency in preparing documentation and training materials