Business Analyst IV – Provider Data

This is a fully remote position, open to applicants in Arizona, +4 more states.

📋 Description

• Act as a senior operational and analytical collaborator for designated National Provider organizations.

• Manage provider-facing coordination, roster reconciliation, provider data integrity, issue resolution, and cross-functional execution across national provider portfolios.

• Convert provider, claims, contract, and operational data into actionable insights.

• Lead the support of business initiatives through data analysis, identifying implementation barriers, and conducting user acceptance testing.

• Spearhead the identification and analysis of user requirements, procedures, and issues to enhance existing processes.

• Address issues and uncover opportunities for process redesign and enhancement.

• Analyze multiple projects, propose business solutions, and ensure successful implementation.

• Assess risks and concerns and communicate them effectively to management.

• Coordinate the development and delivery of training programs in collaboration with business units and departments.

• Cultivate, share, and integrate organizational best practices into business applications.

• Oversee, communicate, and implement modifications to departmental policies and procedures.

• Serve as the subject matter expert on the designated function product.

• Manage day-to-day operational relationships for assigned National Provider groups.

• Organize and lead provider-facing and internal meetings; prepare agendas, executive-ready presentations, status updates, decision logs, and follow-up actions.

• Maintain organized documentation for assigned provider portfolios.

• Validate provider data and manage corrective submissions along with resolution confirmations.

• Perform additional duties as assigned.

⛳️ Requirements

• Must be authorized to work in the U.S. without requiring employment-based visa sponsorship now or in the future.

• Bachelor’s degree in a related field or equivalent experience.

• 6+ years of experience in business process or data analysis, preferably in healthcare, or 5+ years of HEDIS analysis.

• Proficient knowledge of Microsoft Applications, including Excel and Access, is preferred.

• Experience in project management is preferred.

• Ability to perform complex provider roster reconciliations and data-quality reviews across CenProv, Portico, PIX, Xcelys, Amisys, and related reporting tools.

• Understanding of provider data elements such as TIN, NPI, network and line of business, effective dates, locations, affiliations, credentialing cycles, and directory indicators.

• Must adhere to all policies and standards.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K and stock purchase plans.

• Tuition reimbursement opportunities.

• Paid time off in addition to holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in the total compensation package.