Provider Performance Analyst

Relevante New York , NY 10007

Posted 2 months ago

Key Experience Factors:Healthcare Industry; Health Insurance; Excel; SQL; SAS / Access; Analytical Skills;Responsibilities of the Provider Performance Analyst:

Develops and implements data-driven solutions to meet business requirements by producing analytics, reports and data sets

  • Develops and implements data-driven solutions to meet business requirements by producing analytics, reports and data sets across a variety of subject matters – primarily related to, but not limited to, value-based contracting, medical and quality management, population health, network management, contracting, marketing and member outreach, and new business initiatives.
  • Audit data to ensure the maximum level of accuracy, integrity, consistency, and completeness in the various internal/external data sources and in report submissions.
  • Responsible for development, maintenance and settlement of provider incentive models throughout the Family of Companies.
  • Generates and maintains thorough and accurate documentation related to data, databases, value-based contracting models, business rules, and reporting policies and procedures for all LOBs.
  • Identifies data-related issues, and conducts root cause analyses; facilitates resolution of known issues by working directly with end-users and IT staff.
  • Establishes business rules for accurate use of reporting data fields.
  • Identifies new and maintains existing sources of data to ensure the availability of information for reporting purposes.
  • Develops and executes test processes related to end-user data and databases; documents and tracks data-related issues, and facilitates resolution of such issues.
  • Supports identification of training opportunities as they relate to data comprehension and reporting; assists with creation of new models and metrics to track provider performance.

Education/Experience of the Provider Performance Analyst:

  • Bachelors’ degree required in relevant field.
  • Minimum of 3+ years of Data Analysis, Reporting, Claims, Managed Care or Healthcare experience required.
  • Extensive knowledge of Microsoft Office products is required.
  • Demonstrated skills with at least one reporting application such as: SAS Enterprise Guide, SQL and/or MS Access.
  • Experience developing value based programs is preferred.
  • Preferred project management experience including overseeing different initiatives and the coordination and completion of projects on time and within scope.

Benefits of the Provider Performance Analyst:

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Life Insurance
  • Short Term / Long Term Disability
  • Tuition Assistance
  • 401 (k) - employer matched
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Provider Performance Analyst