Senior Provider Network Operations Data Analyst

AmeriHealth Caritas
Southfield, MI, United States
3 days ago

Role details

Contract type
Permanent contract
Employment type
Full-time (> 32 hours)
Experience level
Expert
Experience required
3 years minimum
Working hours
Regular working hours

Tech stack

Microsoft Word Microsoft Excel Data Analysis Data Files Data Integrity Microsoft Office DataOps Computer Network Operations

Job description

Experteer Overview In this role you will serve as the subject-matter expert for Provider Network Operations, enabling accurate and compliant processing of provider data and enrollments. You will train new hires, support analysts through complex questions, and oversee quality and workflow improvements across Facets and related systems. You’ll drive data accuracy, regulatory alignment, and cross-functional collaboration to sustain efficient provider enrollment and data integrity. This position offers remote work with occasional travel, centered on impactful data operations and process optimization. Compensation / Benefits * Serve as the go-to SME for Provider Network Operations processes (provider data, enrollment files, Facets updates) * Train new hires and provide ongoing education to analysts on changing requirements, systems, and reporting needs * Process and oversee complex provider data files and large rosters with high accuracy in Facets and other systems * Monitor workloads, review quality, audit work, and coach analysts to improve accuracy and productivity * Propose and implement process improvements to enhance data quality and enrollment/roster workflows * Ensure data is accurate, complete, and compliant with internal standards and reporting needs; resolve discrepancies promptly * Maintain relationships with provider groups, internal partners, and cross-functional teams for enrollment, data integrity, and issue resolution * Conduct UAT/Client Review & audit reviews prior to submission to EO, and perform capitation reconciliations and membership comparisons * Develop internal reports and engage in regulatory reporting; contribute to BAM/claim reporting as needed * Handle additional duties and special projects as assigned Tasks * Bachelor’s degree or equivalent * 3 to 5 years in data analysis, healthcare operations, or related field * Experience with provider enrollment and changes * Experience developing reports and analyzing complex datasets * Knowledge of Facets or similar healthcare administration platforms * Strong analytical and problem-solving skills * Proficiency in Microsoft Office Suite, especially Excel and Word * Ability to manage multiple priorities in a fast-paced environment * Strong attention to detail and data accuracy * Excellent organizational and communication skills * Experience supporting regulatory reporting and compliance preferred Key requirements *

Requirements

_ quality, audit work, and coach analysts to improve accuracy and productivity * Propose and implement process improvements to enhance data quality and enrollment/roster workflows * Ensure data is accurate, complete, and compliant with internal standards and reporting needs; resolve discrepancies promptly * Maintain relationships with provider groups, internal partners, and cross-functional teams for enrollment, data integrity, and issue resolution * Conduct UAT/Client Review & audit reviews prior to submission to EO, and perform capitation reconciliations and membership comparisons * Develop internal reports and engage in regulatory reporting; contribute to BAM/claim reporting as needed * Handle additional duties and special projects as assigned Tasks * Bachelor’s degree or equivalent * 3 to 5 years in data analysis, healthcare operations, or related field * Experience with provider enrollment and changes * Experience developing reports and analyzing complex datasets * Knowledge of aa with or similar healthcare administration platforms * Strong analytical and problem-solving skills * Proficiency in Microsoft Office Suite, especially Excel and Word * Ability to manage multiple priorities in a fast-paced environment * Strong attention to detail and data accuracy * Excellent organizational and communication skills * Experience supporting regulatory reporting and compliance preferred Key requirements *

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