Health Plan Data Analyst II

October 4

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Medicaid • MyCare Ohio • Health Insurance Marketplace • Medicare Advantage • Health Insurance

1001 - 5000

Description

• The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces. • Demonstrated SQL experience is required. • Participate as a member of Health Partner Lifecycle (HPLC) team on all expansion and provider network development activities • Perform disruption analysis activities for assigned markets • Assimilate large quantities and/or complicated data into meaningful formats for tracking and status requirements • Serve as Project Manager for select HPLC initiatives • In conjunction with HPLC management team, develop Performance Improvement initiatives/corrective action plans to improve quality of provider data and network development • In conjunction with HPLC management team, coordinate activities with regard to provider network data management and reporting • Develop database structures and reports as needed • Develop queries to aid in information retrieval, validation and updating of provider databases • Review provider organizations and systems for development of analyses that support contract negotiation and provider recruitment processes • Work with both internal and external partners to gain information for provider network reporting and analyses • Coordinate and track all State files, hospital, physician and ancillary recruitment information • Prepare NCQA documentation for assigned markets as appropriate • Act as Subject Matter Expert for provider data and impacts to downstream processes • Perform any other job duties as requested

Requirements

• Bachelor’s degree or equivalent years of relevant work experience is required • Minimum of three (3) years of data analysis or experience in a health care setting is required • Managed care experience is preferred • Project management experience is preferred