Research Analyst – Medical Management

📋 Description

• Identify, develop, and implement solutions aimed at enhancing the accuracy and integrity of claims payments throughout the Plan.

• Define PI initiatives and conduct analyses of claims data.

• Create implementation assessment strategies and work collaboratively with both internal and external stakeholders.

• Enhance payment processes by utilizing knowledge of the Providence Health Plan infrastructure and associated functions.

⛳️ Requirements

• A Bachelor's Degree, or 3 years of relevant experience.

• 3 years of experience with performance improvement and organizational change methodologies.

• 3 years of experience collaborating with large data sets and analytics teams.

• 3 years of claims processing experience within the health insurance sector.

• Familiarity with reimbursement methodologies, including those from the Centers for Medicare & Medicaid Services (CMS), provider contracts, and medical coding practices.

• Experience in healthcare project coordination that includes operations analysis, outcomes measurement methodologies, data management, and the design of quality improvement processes.

🏝️ Benefits

• Health care benefits (medical, dental, vision)

• 401(k) Savings Plan with employer matching

• Paid parental leave

• Paid vacations

• Paid holidays

• Time off benefits

• Disability insurance

• Life insurance

• Voluntary benefits

• Well-being resources