Analyst, Operations

Job Description

Job Description

Description :

The Operations Analyst is responsible for accurate and timely maintenance of provider information across all provider databases and systems, and continuously validating the data to ensure adherence to business and system requirements of customers as it pertains to contracting, network management, and credentialing.

This position reports to the Sr. Manager, Contracting & Provider Network Administration within the Operations department.

Responsibilities :

• Timely and accurate maintenance of provider information on all health plan systems, databases, and directories.
• Utilize industry standard sources and best practices to audit and remediate provider data accuracy and quality concerns.
• Perform routine updates to provider data across all internal systems and ensure data synchronization.
• Continuously maintain and audit provider data to ensure quality and accuracy of provider directory information across systems.
• Generate and distribute scheduled reports in accordance with departmental / business requirements.
• Prepare ad-hoc reports as needed for other internal areas (e.g., Provider Services, Member Experience, Claims).
• Assist with enhancements to databases, data collection systems, data analytics and other strategies that optimize statistical efficiency and quality.
• Work collaboratively across the organization to address business needs, determine configuration changes needed and how the changes impact other areas.
• Participates in regular internal and external compliance audits related to provider data.
• Troubleshoot and resolve data-related issues.
• Stay up-to-date on industry best practices, new developments in Provider information exchange, and emerging regulatory and standards-based legislation.

Requirements :

Minimum Qualifications

Professional Competencies

Verda cares deeply about the future, growth, and well-being of its employees. Join our team today!

Job Type : Full-time

Onsite : 100% in-office

Schedule :

Ability to commute / relocate :

PHYSICAL DEMANDS

Regularly sit / walk at a workstation in an office or cubicle setting. Must occasionally lift and / or move up to 25-50 pounds.