Data Analyst

Title: Data Analyst

Location: Mason OH - Hybrid 2 days per week in Mason office)

Contract: 10 Months and Possibility of Extension

Specific Skills Needed:
Top 3-5 mandatory and/or minimum requirements

• SQL/Database experience

• Experience with health provider and network data elements

• Experience with Facets in a managed care setting

• Analytical & problem solving skills

Top 3-5 desirable attributes/qualifications?

• 3+ years of experience focused on data analytics

• Experience with Medicaid and/or Medicare programs and reporting

• Superior communication, critical thinking, teamwork and project management skills

• Experience with Claim adjudication and provider reimbursements

Required levels/ Years of Experience education - discuss whether there is flexibility

• Bachelor's degree or equivalent work experience

GENERAL FUNCTION
Serve as a Data Analyst on the Business Configuration team, responsible for provider agreement, fee schedule and network data integrity initiatives. Provide subject matter expertise for agreement, fee schedule and network setup. Partner with Client cross functional teams to ensure efficiency and accuracy of configuration requests.

MAJOR DUTIES AND RESPONSIBILITIES

• Writing SQL queries to extract data from the database, analysis of configuration data to identify clean-up activities.

• Ensure agreement configuration accuracy that may impact provider payment and member responsibility.

• Set up new Network and Agreement configurations into the Facets system.

• Validate agreement and network configuration utilizing claims testing, SQL queries and Excel to ensure the configuration properly adjudicates during claims processing, for member benefit, reimbursements and provider pay amounts.

• Perform and resolve network and agreement configuration questions/issues sent to the Business Configuration team without guidance.

• Maintain relationships with Account Managers, and Provider teams in order to develop a cohesive cross functional, results driven working environment.

• Self-manage completion of work inventory within established quality and turnaround time guidelines.

• Coordinate and participate in cross-functional team activities for issue resolution.

• Recommend process and system enhancements to drive improvements.

• Support the management team with on-going training activities, misc. projects, resolving issues, and serving as a subject matter expert for all Configuration requests.