Senior Data Quality Analyst, PDM

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee provider data quality initiatives throughout the provider lifecycle management processes.

• Create and sustain data quality frameworks, standards, controls, and key performance indicators (KPIs).

• Detect data quality issues using analytics, audits, monitoring, and input from stakeholders.

• Conduct root cause analysis and suggest corrective and preventive measures.

• Implement quality assurance and validation processes to enhance the accuracy of provider records.

• Lead efforts to resolve provider data discrepancies and address systemic issues.

• Assist in maintaining the accuracy of provider directories and adhering to regulatory compliance standards.

• Track performance metrics and trends of directories impacting member and provider experiences.

• Create and execute controls aimed at enhancing directory accuracy and minimizing regulatory risks.

• Aid in readiness activities, audits, corrective action plans, and regulatory reporting.

• Act as the business lead for provider data governance initiatives.

• Establish definitions, business rules, standards, and stewardship responsibilities for provider data.

• Facilitate governance forums and discussions with stakeholders.

• Analyze provider data across various source systems.

• Develop dashboards and reporting solutions.

• Present findings, recommendations, and progress updates to leadership and cross-functional stakeholders.

• Evaluate provider operational processes and spearhead continuous improvement initiatives.

• Document both current-state and future-state workflows.

• Support automation and technology solutions.

• Collaborate with teams in Network Management, Credentialing, Provider Enrollment, Claims, Digital, Product, Compliance, and Technology.

• Serve as a trusted advisor for provider data initiatives and transformation projects.

• Aid in projects focused on provider data modernization, lifecycle management, and directory optimization.

• Facilitate stakeholder alignment and address cross-functional data quality issues.

• Perform additional duties as assigned by the manager.

⛳️ Requirements

• 5+ years of experience in healthcare provider operations, provider data management, provider enrollment, credentialing, network operations, or related fields.

• 3+ years of experience in leading data quality, data governance, or data integrity initiatives.

• Experience in supporting provider directory operations and managing provider data processes.

• Proven experience in conducting root cause analysis and creating corrective action plans.

• Strong knowledge of healthcare provider lifecycle processes and master data management.

• Proficient in Excel, Power BI, and SQL.

• Experience with Tableau or another data visualization tool.

• Must be available to work during Pacific Time (PST/PDT) business hours.

• Bachelor’s degree in Business Administration, Healthcare Administration, Information Management, Data Analytics, Health Informatics, or a related discipline.

• An equivalent combination of education and experience may be considered.

• In-depth understanding of provider operations, data management, and directory processes.

• Knowledge of workflows related to provider credentialing, enrollment, contracting, and network management.

• Advanced skills in Excel and proficiency with Power BI and SQL.

• Capability to analyze extensive provider datasets and identify data integrity issues.

• Experience in developing KPIs, scorecards, dashboards, and quality monitoring frameworks.

• Advanced proficiency in data analysis and reporting tools.

• Employment sponsorship is not available for this position.

🏝️ Benefits

• Fully remote work.

• Equal Opportunity/Affirmative Action employment.