Sr Analyst, Provider Config (SQL)

Responsibilities

• Responsible for accurate and timely maintenance of critical provider information on all claims and provider databases
• Maintains critical provider information on all claims and provider databases
• Synchronizes data among multiple claims systems and application of business rules as they apply to each database
• Validate data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing
• Generates data to support continuous quality of provider data and developing SOPs and/or BRDs
• Develops and maintains documentation and guidelines for all assigned areas of responsibility
• Assists with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality
• Assists in planning and coordination of the claim payment system upgrades and releases, including development and execution of some test plans
• Participates in the implementation and conversion of new and existing health plans
• Collaborate with stakeholders to understand business objectives, gather requirements, and translate them into comprehensive business and functional specifications
• Analyze complex healthcare data sets to identify trends, patterns and insights that drive informed decision-making and process improvements
• Evaluate existing workflows, procedures, and systems to identify inefficiencies and opportunities for optimization, proposing and implementing innovative solutions
• Lead and support cross-functional projects from initiation to completion, ensuring adherence to timelines and quality standards
• Establish and maintain strong relationships with key stakeholders ensuring alignment and collaboration across departments
• Develop presentations to communicate key metrics, performance indicators and actionable insights to stakeholders at all levels of the organization
• Provide training, support, and guidance to end-users on new processes, systems, and tools, ensuring smooth implementation and adoption

Skills

• SQL language experience, including scripting, developing, creating new scripts for report building and creation

Qualifications

• Bachelor's Degree or equivalent combination of education and experience
• 5-7 years
• Graduate Degree or equivalent combination of education and experience
• 7-9 years

Benefits

• 🏥 Health Insurance