South Carolina Operations Analyst

Job Summary

A company is looking for a Provider Network Operations Analyst.

Key Responsibilities

• Facilitate or perform root cause analysis to identify issues and improve processes for Medicaid claims
• Develop reports, studies, and data models related to monitoring operational accuracy
• Define and implement data modeling tools or reports to assess and improve existing operations

Required Qualifications

• High School Diploma or GED required
• Bachelor's Degree or equivalent education and experience preferred
• 3 to 5 years of healthcare claims experience preferred
• Experience in report writing, data analysis, and data research in Medicaid managed care operations preferred
• Medicare or Commercial background also acceptable