2 Sr. Provider Data Analyst - Health Plan (55783) Jobs in Indianapolis, IN
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Professional Management Enterprises is Hiring a Sr. Provider Data Analyst - Health Plan (55783) Near Indianapolis, IN
- Responsible for accurate and timely identification of critical information on configuration and claims databases.
- Oversees operational and claims systems and application of business rules.
- Validates data to be housed on databases and ensures adherence to business and system requirements of health plan and other business requirements.
- Accurately interprets specific state and/or federal benefits, contracts as well as additional business requirements.
- Oversees coding, updating, and maintaining benefit plans, provider contracts, fee schedules and various system tables.
- Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.
Bachelor's Degree or equivalent combination of education and experience
Required Experience:
2-5 years of relevant work experience.Experience with MS Office applications required, especially strong Excel skill. Skill with SQL or SAS.Experience with data management and analysis preferred.Must have strong quantitative and analytical skills.Experience in health care industry desired.It is the policy of the Company to provide equal employment opportunities to all qualified individuals and to administer all aspects and conditions of employment without regard to the following:
• Race and associated traits, including hairstyle; Color, Age, Sex, Sexual orientation, Gender, Gender identity and gender expression; Religion, including dress and grooming practices; National origin, including language use restrictions; Pregnancy, childbirth, or breastfeeding; Marital or familial status; Genetic information, including family medical history; Physical or mental disability; Citizenship and/or immigration status
• Medical conditions, including cancer, AIDS/HIV, and occupational pneumoconiosis without respiratory impairment
• Denial of family or medical care leave
• Use of a guide or support animal
• Military or veteran status
• Political activities or affiliations
• Exercise of civil rights
• Domestic violence, assault, or stalking victim status
• GED certificate
• Arrest, expunged, or sealed records
• Application for or enrollment in Medi-Cal
• Status as a smoker or non-smoker
• Credit report or credit information
• Child or spousal support withholding
• Wage garnishment for consumer debt
• Relationship with someone with a disability
• Lawful conduct occurring during nonworking hours not on Company premises
• Any other protected class, in accordance with applicable federal, state, and local laws
Discriminatory, harassing, or retaliatory behavior is prohibited from coworkers, supervisors, managers, owners, and third parties, including clientele. The Company takes allegations of discrimination, harassment and retaliation very seriously and will promptly conduct an investigation when warranted. Equal employment opportunity includes, but is not limited to, employment, training, promotion, demotion, transfer, leaves of absence and termination.
Job Summary
Full Time
Business Services
$90k-118k (estimate)
04/23/2024
04/25/2024
pme-indy.com
INDIANAPOLIS, IN
200 - 500
2005
HASKELL PORTEE
$10M - $50M
Business Services
Related Companies
About Professional Management Enterprises
PME is a Minority and Service Disabled Veteran Owned Business founded in 2006, that is a highly valued teaming partner in multiple states to large corporations such as Humana, KPMG, Ernst and Young, Anthem, and HP to name a few. Additionally, we provide services in the areas of healthcare, IT, and professional services to Department of Defense and other Federal Government clients. We also are highly engaged in state work in our home state of Indiana, as well as multiple other states nationwide. We successfully leverage our abilities in Healthcare, Managed Care, IT, and Human Capital Services w...ith our flexibility and robust performance.
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