• Data Analyst I

    Job Locations US-VA-Glen Allen
    Job ID
    2018-4939
  • About Us

    Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.
    By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.
     
    At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.
     
    If this sounds like you, read on!

    Overview

    This position is primarily responsible for assisting the Manager of Analytics with all activities relating to Network Development data, including maintaining and analyzing data integrity to adhere to all requirements under the CMS and DMAS program.

     

    Responsibilities

    • Ensure Network Development Department adheres to the guidelines set forth by accreditation and regulatory organizations (i.e. NCQA, DMAS). 
    • Coordinates resolution of problems with the state of Virginia, Centers for Medicare and Medicaid and related regulatory organizations. 
    • Coordinates internal compliance audits for the department. 
    • Develops an expertise in reporting, vendor contracts, capitation, vendor setup and member assignments in the IDX and QNXT claims platforms 
    • Assists with the data auditing functions related to provider data and vendor set up through internal reporting tools. 
    • Assist with the ETL process of both internal and external facing Network Development data 
    • Researching and reporting data quality issues and develop process for data improvement 
    • Assists Provider Reps and Contracting staff in researching and resolving provider setup issues

    Qualifications

    MINIMUM EDUCATION REQUIREMENTS

    • Four (4) year college degree from an accredited institution required

    SPECIAL KNOWLEDGE AND/OR SKILLS

    • Strong analytical and technical skills- experience using Microsoft Access, Excel, SQL
    • Openly and actively communicates information and takes initiative to communicate       
    • Handles difficult situations diplomatically
    • Ability to build strong relationships within and outside the health plan

     WORK BACKGROUND/EXPERIENCE

    • Experience in an analytical capacity preferred
    • Previous experience in provider services and contracting helpful

    PHYSICAL REQUIREMENTS

    • Physical health sufficient to meet the ergonomic standards and demands of the position 

    All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

     

    Our mission is to inspire healthy living within the communities we serve!

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