Role Description

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Provider Data Analyst - REMOTE. In this critical role, you will support the governance, quality, and operational effectiveness of provider data across the health plan ecosystem. Your work will focus on analyzing provider data trends and identifying systemic issues as well as improving processes for provider onboarding, credentialing, claims adjudication, and provider directory accuracy. Collaborating closely with various operational teams, you will ensure data flows are precise and integrated, ultimately contributing to enhanced decision-making and operational integrity in the field of healthcare data management.

Accountabilities

• Monitor provider data quality across operational systems and identify systemic data issues affecting claims payment.
• Develop and maintain data validation rules and quality checks to ensure provider data integrity.
• Analyze provider data discrepancies and lead root cause investigations.
• Analyze trends in provider data errors, claims rejections, and onboarding issues.
• Identify recurring operational problems and recommend process improvements.
• Develop dashboards and reports that provide visibility into provider data performance.
• Evaluate how provider data flows between systems including credentialing and claims processing.
• Identify data gaps and inconsistencies across systems and external partners.
• Support system enhancements related to provider data integration.
• Identify opportunities to streamline provider data intake and distribution processes.

Qualifications

• Bachelor’s degree in healthcare administration, data analytics, information systems, business, or a related field.
• 3–6 years of experience with healthcare provider data and credentialing operations.
• Strong understanding of healthcare provider identifiers including NPIs and TINs.
• Experience analyzing operational healthcare data related to claims processing.
• Strong analytical and problem-solving skills.
• Advanced Excel skills including data analysis and reporting.
• Experience with data warehouses, SQL, or reporting tools such as Tableau or Power BI.
• Familiarity with provider credentialing standards and verification processes.

Benefits

• 401K with company match.
• Comprehensive health and wellness packages.
• Internal mobility team dedicated to career development.
• Professional growth opportunities including training and conference attendance.
• Cutting-edge technology and tools for your learning.
• Paid vacation and holiday time.
• Remote work flexibility.