The Health Plan Data Analyst II is responsible for extracting, analyzing, reporting, tracking and monitoring provider data across business functions, systems and interfaces in the Provider Data Claims Support area.
Requirements
- Experience with Cognizant Facets Provider application is required
- Advanced Microsoft Excel, Access, and Word skills
- Knowledge and understanding of Facets data model
- Proficient in data analysis and use of analytics / reporting tools such as Power BI
- Demonstrates analytical and supporting technical skills to include SQL capabilities
- Experience with Visio and PowerPoint preferred
- Working knowledge of provider data repositories and directories preferred
Responsibilities
- Perform disruption analysis activities for assigned markets
- Assimilate large quantities and/or complicated data into meaningful formats for tracking and status requirements
- Develop database structures and reports as needed
- Develop queries to aid in information retrieval, validation and updating of provider databases
- Review provider organizations and systems for development of analyses that support contract negotiation and provider recruitment processes
- Work with both internal and external partners to gain information for provider network reporting and analyses
- Prepare NCQA documentation for assigned markets as appropriate
Other
- Participate as a member of Provider Data Claims Support (PDCS) team to support existing provider data operations and new market implementations
- Serve as Project Manager for select PDCS initiatives
- In conjunction with PDCS management team, develop Performance Improvement initiatives/corrective action plans to improve quality of provider data and network development
- In conjunction with PDCS management team, coordinate activities with regard to provider network data management and reporting
- Coordinate and track all State files, hospital, physician and ancillary recruitment information
