Provider Network Data Integrity Analyst, Health Plan

🔥 2 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $24 - $38 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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Sanford Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1894

⚕️ Healthcare Insurance

Healthcare Insurance

Sanford Health is the largest rural health system in the United States, dedicated to transforming the healthcare experience and providing access to world-class healthcare in America's heartland. Headquartered in Sioux Falls, South Dakota, Sanford Health serves over 1. 4 million patients and nearly 200,000 health plan members across 250,000 square miles. The integrated health system includes 48 medical centers, 211 clinic locations, and more than 160 senior living centers, employing 2,900 physicians and advanced practice providers. Sanford Health is committed to offering compassionate care through its Centers of Excellence, focusing on specialties such as cancer, orthopedics, women’s health, and genetics. Additionally, it provides affordable health insurance, engages in extensive clinical trials, and supports personalized genetic medicine.

📋 Description

• Responsible for the accuracy, completeness, and required regulatory filings of the Health Plan’s provider network. • Serves as a resource for strategic planning, compliance, and network analysis. • Completes network adequacy reviews, in collaboration with the Health Plan's Business Intelligence Department representatives. • Performs analyses and audits to identify gaps in current provider networks. • Coordinates required regulatory provider network submissions to ensure HP meets contractual obligations. • Maintains accurate data in HP Provider Directory.

🎯 Requirements

• Bachelor’s Degree in business administration, finance, healthcare related field, computer science, or analytics. • Successful completion of a post-secondary medical terminology course preferred. • Three years’ experience in a medical group practice, health insurance or Health Maintenance Organization (HMO) environment. • Demonstrated knowledge of data manipulation and analytical analysis. • Proficiency with Microsoft Office suite to include products, Excel and Access. • Understanding of geoaccess coding, provider credentialing, and medical terminology preferred.

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off