Provider Network Data Integrity Analyst, Health Plan
Job Description:
- Responsible for the accuracy, completeness, and required regulatory filings of the Health Plan’s provider network.
- Serves as a resource for strategic planning, compliance, and network analysis.
- Completes network adequacy reviews, in collaboration with the Health Plan's Business Intelligence Department representatives.
- Performs analyses and audits to identify gaps in current provider networks.
- Coordinates required regulatory provider network submissions to ensure HP meets contractual obligations.
- Maintains accurate data in HP Provider Directory.
Requirements:
- Bachelor’s Degree in business administration, finance, healthcare related field, computer science, or analytics.
- Successful completion of a post-secondary medical terminology course preferred.
- Three years’ experience in a medical group practice, health insurance or Health Maintenance Organization (HMO) environment.
- Demonstrated knowledge of data manipulation and analytical analysis.
- Proficiency with Microsoft Office suite to include products, Excel and Access.
- Understanding of geoaccess coding, provider credentialing, and medical terminology preferred.
Benefits:
- Health insurance
- Retirement plans
- Paid time off
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