Provider Network Analyst

Job Summary

Provider Network Analyst is a full-time position responsible for ensuring the accuracy and regulatory compliance of the Health Plan's provider network data, including network adequacy filings and data integrity maintenance.

Key Responsibilities

• Develop and enforce data quality standards within the provider and facility database
• Complete network adequacy reviews and collaborate with the Business Intelligence Department
• Coordinate regulatory provider network submissions and maintain compliance with CMS and other agencies

Required Qualifications

• Bachelor's Degree in business administration, finance, healthcare related field, computer science, or analytics
• Three years' experience in a medical group practice, health insurance, or HMO environment
• Demonstrated knowledge of data manipulation and analytical analysis
• Proficiency with Microsoft Office suite, including Excel and Access
• Understanding of geoaccess coding, provider credentialing, and medical terminology preferred