Provider Data Analyst Job Description
Provider Data Analyst Duties & Responsibilities
To write an effective provider data analyst job description, begin by listing detailed duties, responsibilities and expectations. We have included provider data analyst job description templates that you can modify and use.
Sample responsibilities for this position include:
Provider Data Analyst Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Provider Data Analyst
List any licenses or certifications required by the position: PMO
Education for Provider Data Analyst
Typically a job would require a certain level of education.
Employers hiring for the provider data analyst job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and High School Degree in Education, Healthcare, Management, Medical, Business, Computer Science, Mathematics, Statistics, Associates, Health Care
Skills for Provider Data Analyst
Desired skills for provider data analyst include:
Desired experience for provider data analyst includes:
Provider Data Analyst Examples
Provider Data Analyst Job Description
- Establish 'Ask a Question' dialogue with GL 23 Provider Data Specialists and the GL 24 Sr
- Use pertinent data and facts to identify solve a range of problems within provider network operations area of expertise
- Follow up with the appropriate staff members from across UHC, Optum, Medicare and Retirement or Community and State IT areas on open issues and to gather information
- Develops and analyzes business performance reports
- Creates and publishes periodic reports, any necessary ad hoc reports
- May make recommendations based upon data analysis
- Develops and maintain standards for database integrity and quality assurance, coordinates corrective activities to clean database and retain users, and manages communication processes with other departments regarding database improvements
- Identify and accurately analyze data file components to complete record set-up of practitioners and facilities
- Manage data integrity within multiple databases
- Actively anticipate and report potential areas of concern within data and in consideration of downstream processes
- Proven ability providing reports, identifying trends, communicating results, and recommendations
- 3+ years working any of the following (SSRS, Tableau, Business Object, OBIEE)
- Python / R / SAS experience
- Bachelor degree (or higher) or High School Diploma/GED with 2+ years previous PVO experience
- Highly effective communication skills, including the ability to provide constructive feedback in a manner likely to be well received
- Claims processing knowledge preferred but not required
Provider Data Analyst Job Description
- Act with a sense of urgency to research questions or issues raised by both internal and external customers
- Intake provider data from multiple sources
- Prepares provider network analyses and lead reporting activities for the Provider Services Department
- Creates reports and provider profiles for Network Management Committee, Health Board of Directors, and regulatory agencies such as the Department of Healthcare Services and Managed Healthcare
- Coordinate provider reimbursement and configuration efforts in the Provider Services Department, including contract implementation and review of State operating instruction letters
- Serve as a provider configuration resource for Provider Services Representatives and -Data Specialists
- Participate as the lead from the Provider Services Department on the System Change Form (SCF) workgroup and other cross departmental workgroups
- Coordinate Provider Services Department submissions and ensure accurate and thorough implementation for provider-related projects
- Fulfill assigned requests for provider information, as mandated by the State Department of Health Services, Medical Risk Management Insurance Board and other governing agencies and bodies
- Maintain technical skill sets across a broad range of software languages, databases and platforms that will be used in the development and production of analyses and reporting solutions
- Experience creating databases using SQL Server and MS Access
- FACETS preferred
- 1+ years provider experience
- 2+ year workflow experience
- Microsoft Visio advanced skills
- Workflow creation and documentation (i.e., standard process flow) experience using Visio
Provider Data Analyst Job Description
- Documents and coordinates complex, cross functional analytic and reporting solution test plans
- Provides provider relations representatives with tools
- Leverages advanced statistical/data analytic techniques
- Owning the quality & utility of clients’ provider data
- Investigating provider data anomalies relating to specific clients
- Assisting as project SME on provider data issues
- Focusing on resolving provider data issues associated with complex clients
- Identifying ways to enhance on provider data prior to implementation of new data model
- Redesigning provider data protocols in anticipation of client changes & implementations
- Experience in either leading or participating in quality projects (Six Sigma and )
- Provider contract load experience
- Demographic experience across multiple platforms
- Demonstrated independent work initiative demonstrated successful team project participation
- Understanding of SQL/SDLC, with ability to become proficient in writing SQL
- Be detail-oriented and possess a strong analytical ability
- 5+ years of relevant experience in data analytics/ specification writing
Provider Data Analyst Job Description
- GeoAccess availability reports (standard and ad hoc)
- Regulatory provider report preparation and distribution to state agencies
- Provider Online Directory (POD)– ongoing execution, QA and maintenance of supporting tables
- Medicare provider directory preparation
- Other regulatory reporting as assigned
- Conducts outreach for our vendor to assure accuracy in CPF/PWB/Facets/HCPM/Proclaim
- Reviews incoming work for information that may be missing and accuracy of information
- Develops accurate and specific programming specifications for electronic data exchanges and data transfers between the company and clients, brokers and vendors
- Serves as a subject matter expert for Provider healthcare data, and in this role, assists the company staff, clients, brokers and vendors with interpreting and understanding the data
- Assists the Data Management team with executing, validating and assembling organized analytics regarding healthcare quality and compliance measures for all supported lines of business
- Knowledge of SQL highly desired
- Bachelor’s Degree in Business or equivalent administrative/ business/experience
- Five (5) years’ experience in managed care desired
- Five years of analytical experience desired
- 5 years’ reporting development and programming experience required
- In-depth knowledge of systems development life cycle and/or operational maintenance environment required
Provider Data Analyst Job Description
- Proactively identifies issues and opportunities to enhance data management and interchange through detailed and high-level problem solving to ensure consistent delivery of world-class services to assists the company staff, clients and brokers
- Recommends and implements procedural and data flow changes to increase the accuracy, effectiveness, and efficiency of products and services delivered by the Data Management team
- Creates and maintains operational procedure documentation for Data Management processes
- Management and creation, maintenance, and design of integration strategies regarding claims and healthcare data
- Responsive to internal end user and external client needs regarding data extracts and data integration
- The end users receive first-level analysis in a timely manner
- Understands the goals of the Data Management team and works within a team environment to ensure that these goals are met
- Research root cause of issues relative to provider data loads
- Bachelor’s degree required with 3-5 years relevant experience working with health care data
- Strong proficiency with SQL and experience with relational databases
- 3 years of experience with SQL, VB, or comparable programming language strongly preferred
- Proven analytical, design, and coding skills and have demonstrated success in leading small to medium size projects
- Oral and written communication skills, including basic facilitation/presentation skills are required
- Proficient on development environments or programming languages
- MS SQL Server knowledge and hands on experience with database management and architecture preferred
- Familiarity with geoanalysis tools (Quest Analytics, Directory Expert, GeoCoder, GeoAccess, DataCleaner, etc) or their alternatives preferred