Professional, Provider Data Analysis and Implementation #875
The goal for this role is to improve provider data accuracy to meet regulatory requirements and improve member experience
Primary Duties include:
- Research- Define and maintain the requirements for provider data regulations. Identify member/provider abrasion issues and trends.
- Measure- Design and implement metrics to track improvement trends.
- Strategize- Create plans for each regulatory requirement and abrasion point.
- Identify inaccuracies in data and Root Cause.
- Develop and Implement initiatives that improve the member experience and memberfacing provider search data.
- Implement monitoring and controls to track the data improvements over time.
- Implement vendor provider data validation solution(s). Create a quarterly automated process to update addresses, phone numbers, NPI’s etc.with addresses, phone numbers, NPI’s etc. in multiple databases.
- Perform outreach to providers and facilities for required data as needed.
- All team members are expected to continuously evaluate processes, identify potential improvements and help implement changes.
- Performs other duties as assigned
Bachelor’s degree in business, Computer Science, Information Systems or three or more years of related work experience.
Three plus years of experience in business process, data analysis and project implementation. Health insurance experience preferred. Experience working within Agile Scrum methodology beneficial.
- Ability to thrive in an entrepreneurial environment: a curiosity and eagerness to solve big challenges and ability to manage projects independently.
- Must have excellent communication and presentation skills, clearly articulating initiatives, and analyses to technical and non-technical teams alike.
- Strong results-oriented team player with a passion for driving cross functional collaboration
- Proven leadership skills.
- Ability to manage multiple assignments with a high level of autonomy and independence.
- Highly detail-oriented with strong analytical, technical, and interpersonal skills.
- Adept in Microsoft Word, Excel, PowerPoint, and the management of data and reports.
- Proficiency in project management skills and software tools.
- Experience in strategic planning, risk management and/or change management.
- Exceptional skills in critical thinking and problem solving.
- Excellent organizational and communication skills.
- Skilled in decision-making and conflict resolution
- Ability to work collaboratively and professionally
- Able to handle stress and multiple competing priorities simultaneously.
- Ability to maintain confidentiality and adhere to regulatory compliance issues as they exist and change from time to time.
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for more than 700,000 members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse, employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve. MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the EEO is the Law Poster and Supplement protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at email@example.com
Please apply and learn more – including how you may become a proud member of our team.