Business Analyst IV – Provider Data

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🌵 Arizona, California, +3 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🐊 Florida – Remote 🏰 Missouri – Remote 🤠 Texas – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Business Analyst

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Serve as a senior operational and analytical partner for assigned National Provider organizations • Own provider-facing coordination, roster reconciliation, provider data integrity, issue resolution, and cross-functional execution across national provider portfolios • Translate provider, claims, contract, and operational data into actionable recommendations • Lead support of business initiatives through data analysis, implementation-barrier identification, and user acceptance testing • Lead identification and analysis of user requirements, procedures, and problems to improve existing processes • Resolve issues and identify opportunities for process redesign and improvement • Analyze multiple projects, recommend business solutions, and ensure successful implementations • Evaluate risks and concerns and communicate them to management • Coordinate development and delivery of training programs with business units and departments • Develop, share, and incorporate organizational best practices into business applications • Oversee, communicate, and implement changes to departmental policies and procedures • Serve as subject matter expert on the assigned function product • Own day-to-day operational relationships for assigned National Provider groups • Plan and lead provider-facing and internal meetings; develop agendas, executive-ready presentations, status updates, decision logs, and follow-up actions • Maintain organized records for assigned provider portfolios • Validate provider data and coordinate corrective submissions and resolution confirmation • Perform other duties as assigned

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Bachelor’s degree in related field or equivalent experience • 6+ years of business process or data analysis preferably in healthcare or 5+ years of HEDIS analysis • Advanced knowledge of Microsoft Applications, including Excel and Access preferred • Project management experience preferred • Ability to perform complex provider roster reconciliations and data-quality reviews across CenProv, Portico, PIX, Xcelys, Amisys, and related reporting tools • Knowledge of provider data elements including TIN, NPI, network and line of business, effective dates, locations, affiliations, credentialing cycles, and directory indicators • Must comply with all policies and standards

🏖️ Benefits

• Competitive pay • Health insurance • 401K and stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation