Provider Operations Analyst II (Health Plan/Provider Data Experiencr)

Job Summary: The Provider Operations Analyst II is responsible for assimilating large quantities and/or complicated data into meaningful formats for tracking and status requirements. Essential Functions: Develop queries to identify and quantify provider data issues within the organization and assist in the development plans to resolve data issues Provide operations teams; Contracting, Credentialing, Data Load, Directories, and Pended Claims with analysis and oversight for all provider data, workflows and processes Act as Subject Matter Expert (SME)/Business Analyst/Data Analyst for Provider Operations team on various initiatives/special projects Work cross functionally with Claims, Configuration, Market Reps, and Provider Operations to integrate business processes and workflows Identify, develop, and implement reporting and/or business processes to ensure adherence to data quality, operational excellence, regulatory and compliance requirements Develop and monitor daily metrics for staff quality, productivity, making recommendations for change as needed Manage and conduct root cause analysis for high-level escalations that involve intensive research and resolution Manage special pr…