Data Analyst, PIM in Orange at Prospect Medical Systems

Date Posted: 7/12/2020

Job Snapshot

Job Description



Data Analyst, PIM

We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care. We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives. Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.

This position is responsible for analysis of the system of records for internal and external users and the provider data universe including but not limited to network and gap analysis, reporting and metrices. Collaborates with leadership within and outside department to work on projects and see it through completion. Assists leadership with custom reporting and with training for PIM related programs as needed. Validates the accuracy of data from various sources on an ongoing business and tracks and resolves anomalies.  Individual is responsible for being a resource for other team members.  Individual must be highly motivated, able to establish rapport and interact well with individuals on all levels while maintaining a professional image and attitude.



Job Responsibilities/Duties

  • Oversee the data accuracy and validation efforts
  • Ensure timely generation of HP roster
  • Assists the team with provider data validation efforts including but not limited to developing custom forms, automating the process to increase response rate from providers
  • Perform regular reporting functions and assist the team with ad-hoc report requirements
  • Assist with tracking and monitoring unassigned members and Provider ID’s
  • Assist team with reporting for quality audits
  • Identify and pursue process improvement opportunities to enhance data accuracy and achieve higher efficiency.
  • Assists the team with special projects including data load for new businesses and meet data needs for the existing records
  • Perform routine data validation to ensure data is up to date and accurate
  • Work on automation opportunities that will assist the team to be more efficient and ensure greater response rate from provider outreaches
  • Create and maintain custom formats for rosters and help the team generate the files per Health Plan requirements
  • Coordinate with the third-party vendor to ensure data is transmitted and received using the correct file and data format/layout.  
  • Identify issues with data and coordinate with other departments to ensure data standards are being maintained.
  • Monitor communication from internal and external sources to identify changes in requirements (from HP or Regulatory or Internal business needs)
  • Coordinate with Compliance, manager and leadership to identify the required changes and their priority
  • Track, monitor and implement the changes to ensure compliance. Work closely with IT to ensure timely and accurate delivery of required solutions
  • Assist the trainer to ensure the changes are communicated to the team timely
  • Ensure compliance is met through monitoring responses from Health Plans and Corrective Action Plan’s (CAP) and making necessary process changes.
  • Timely report of scheduled productivity reporting and ad hoc report requests. Create processes to streamline the process
  • Assists the department manager to create, manage and maintain all departmental and external policy and procedure documents and SOP’s


Qualifications

Minimum Education: 4 year college degree or equivalent years of experience (preferred)

Minimum Experience: Minimum of 5 years of HMO/IPA experience in Provider enrollment, Network Management or Contracting. IPA Operations experience strongly recommended. Proficiency in word (Advanced), excel (Advanced), pivot tables (Advanced), SQL (Intermediate), Microsoft access (Basic – Intermediate), Other Office suites (Intermediate) and Sharepoint (intermediate) preferred.

Excellent verbal communication skills and interpersonal skills. Able to establish rapport and interact well with individuals on all levels. Maintain a professional image and attitude. Knowledge of table structures in large databases. Strong public speaking and presentation skills. Successful prioritization, organization and completion of multiple tasks. Ability to make decisions in the absence of detailed instructions and work independently or in a team environment. Must have advanced reasoning and problem solving abilities and planning skills. Ability to interpret a variety of instructions furnished in written, oral, diagram, and schedule form. Ability to speak, read, and writes English proficiently. Ability to write business correspondence. Ability to effectively present information and respond to questions from managers, employees, clients, customers and the general public. Demonstrate exceptional verbal/written/communication skills. Fluent in a foreign language that is applicable to any Prospect affinity network. Supervises or manages support staff as applicable.

Req. Certification/Licensure: None.



Employee Value Proposition

Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core. This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts. As a member of our highly effective team of professionals you will receive:

  • Company 401K
  • Medical, dental, vision insurance
  • Paid time-off
  • Life insurance


How to Apply

To apply for this role, or search our other openings, please visit http://pmh.com/careers/ and click on a location to begin your journey to a new career with us!

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources.

EEOC is the Law: https://www1.eeoc.gov/employers/poster.cfm

Keywords: Data Analyst, reporting, word, excel, pivot tables, SQL, Microsoft access, Sharepoint



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