Provider Data Analyst Job Vacancy in Health Network One Fort Lauderdale, FL 33316 – Latest Jobs in Fort Lauderdale, FL 33316
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Company Name : Health Network One
Location : Fort Lauderdale, FL 33316
Position : Provider Data Analyst
Job Description : Health Network One is the leader in managing specialty healthcare networks. Founded in 1999, we are a rapid growing, private equity-backed company that delivers cost savings to our health plan customers, world-class service to our provider networks, and access to quality healthcare for health plan members.On behalf of our health plan clients, we manage the entire network value chain, including utilization management, claims, and provider management. Our specialty networks exceed 10,000 providers and include outpatient therapy, dermatology, podiatry and more. Today we operate in four states and are expanding into four more; in total, we cover more than 5,000,000 lives.Job/Position Summary:Update and compile reports for Health Plans, Providers and internal departments. Support the Department in completing and tracking of Client audits. Learn various internal software tools to assist in utilization reviews and adequacy of provider networks.Essential Functions & Responsibilities:Assist the Provider Network Department in completing monthly and quarterly reporting requirements to its ClientsRequires strong analytical skills to thrive in a fast paced environment as well as be comfortable with management exposure.Refresh the data files monthly of the current health plans in order to review the Network adequacy of our provider specialties.Assist department in reviewing network accessibility (including quarterly geo-map analysis).Assist department in annual audits from health plans.Refresh the data to analyze the claims utilization and cost performance of the specialty networks.Assist department in reviewing network accessibility (including quarterly geo-map analysis).Work on various special projects and ad-hoc reports on an as needed basis.Work and support multiple members of the department conducting research via the internet, internal software programs, spreadsheets, health plan directories, etc. to support the department with current and new projects. Research information may be requested in various reporting formats.Must support company philosophies, objectives, decisions and policies.Ensure adherence to department and organizational standards, policies and procedures, including HIPAA.Ensure integrity of data entered into Company systems and/or databases.Ability to safely and successfully perform essential job functions consistent with the ADA, FMLA, and other federal, state, and local standards, including meeting qualitative and/or quantitative productivity standardsCompliance with all personnel policies and procedures.Ability to work both independently and as part of a team of professionals.Excellent analytical and problem solving skills.Proficient in Excel, knowledge in Access, GEOmaps, SQLMust have strong organizational skills, and have the ability to Multi-task.Strong interpersonal and verbal and written communication skills.Knowledge of with various aspects of billing, claims adjudication and claims payment for the network specialties. This should include, but may not be limited to Medical terminology, CPT Coding, ICD Code Sets, and CMS Fee Schedules.Required Education and Experience:Bachelor’s degree or equivalent work experience in data analysis experienceTwo or three years background in the Care Managed Organization (HMO, TPA, healthcare industry.)Health Network One is an equal opportunity EmployerJob Type: Full-timePay: From $50,000.00 per yearBenefits:401(k)401(k) matchingDental insuranceFlexible spending accountHealth insuranceLife insurancePaid time offVision insuranceSchedule:Monday to FridayCOVID-19 considerations:To keep our employees as safe as possible, we’ve installed higher Plexiglas at the cubicles, provided masks, and hand sanitizer, maintaining 6 feet social distancing and adhering to the CDC guidelines and State and Local regulations.Experience:Health information management: 3 years (Required)Work Location: One location
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