SCOPE OF ROLE

Our Provider Data team is responsible for partnering with our Care Partners to turn their provider networks into market leading integrated delivery systems. We are reimagining how the network development, network management, and provider relations functions can advance affordable, simple, and personal care for our members. As the Provider Data Analyst, you will have the opportunity to work closely with our Care Partners and other participating providers to build and strengthen the foundation of provider data exchanges between our organizations. You will serve as a key contributor to the strong data connection between Bright and our network participants.

ROLE RESPONSIBILITIES

The Provider Data Analyst job description is intended to point out major responsibilities within the role, but it is not limited to these items.

RESPONSIBILITIES

• Manage all current and future provider data from contracted entities
• Continuously streamline and improve our provider data structure
• Work with a delegated employee inside of our Care Partner to obtain mandatory data elements, updates, and any data improvements
• Assist in keeping the Provider Data group organized between contracting, fee schedule creation, and provider database
• Assist in creating business rules, understanding specific requirements, and working with our team to create needed provider data extracts
• Acts as the subject matter expert on provider data, provider database, provider data ecosystem
• Creates specialty mapping for new care partners and new vendors
• Supports team in provider audits and filings that happen through the year to include providing ad hoc provider data reports and participating in calls as appropriate
• Handles escalated provider data issues that have a verified root cause of a provider data error
• Maintain low queue volume on provider maintenance and non-par claims
• Participates in cross-department teams to analyze business opportunities and address critical issues
• Other duties and responsibilities as assigned.

SUPERVISORY RESPONSIBILITIES

This position does not have supervisory responsibilities.

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Highschool diploma or GED required; Bachelor’s degree in related field preferred
• Three (3) or more years of in data analytics, provider/customer relations, data entry, and/or project management required.
• High proficiency in Microsoft Excel and, preferably, experience in SQL, Access, and Database management
• Previously worked in a customer (provider) facing role

PROFESSIONAL COMPETENCIES

• Collaborative and relationship-driven style in building effective data transmissions between entities
• Strong ability to problem solve and proven ability to learn quickly and work independently.