SCOPE OF ROLE
Our Provider Data team is responsible for partnering with our Care Partners to
turn their provider networks into market leading integrated delivery systems.
We are reimagining how the network development, network management, and
provider relations functions can advance affordable, simple, and personal care
for our members. As the Provider Data Analyst, you will have the opportunity
to work closely with our Care Partners and other participating providers to
build and strengthen the foundation of provider data exchanges between our
organizations. You will serve as a key contributor to the strong data
connection between Bright and our network participants.
The Provider Data Analyst job description is intended to point out major
responsibilities within the role, but it is not limited to these items.
- Manage all current and future provider data analysis and reporting needs
- Continuously streamline and improve our provider data structure
- Work with a delegated employee inside of our Care Partner to obtain mandatory data elements, updates, and any data improvements
- Assist in keeping the Provider Data group organized between contracting, fee schedule creation, and provider database
- Assist in creating business rules, understanding specific requirements, and working with our team to create needed provider data extracts
- Acts as the subject matter expert on provider data, provider database, provider data ecosystem
- Creates specialty mapping for new care partners and new vendors
- Supports team in provider audits and filings that happen through the year to include providing ad hoc provider data reports and participating in calls as appropriate
- Handles escalated provider data issues that have a verified root cause of a provider data error
- Monitor CMS and other regulatory or industry requirements that should be applied to the department
- Participates in cross-department teams to analyze business opportunities and address critical issues
- Other duties and responsibilities as assigned.
This position does not have supervisory responsibilities.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- High school diploma or GED required; Bachelor’s degree in related field preferred
- Three (3) or more years of data analytics required
- Provider/customer relations, data entry, and/or project management experience preferred
- High proficiency in Microsoft Excel and, preferably, experience in Access, and Database management. Experience with Quest Analytic tools helpful.
- Previously worked in a data management/analyst role
EEO/AFFIRMATIVE ACTION STATEMENT
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a
diverse employee group committed to meeting the needs of Bright Health, our
consumers, and the communities we serve. All qualified applicants will receive
consideration for employment without regard to race, color, religion, sex,
age, national origin, protected veteran status, disability status, sexual
orientation, gender identity or expression, marital status, genetic
information, or any other characteristic protected by law