Req Number 001UES
Job Category Information Technology
Supports Network operations through maintenance of demographic, billing and other information in provider database. Ensures timely, accurate generation and distribution of required reports and analysis in support of continuous quality improvement of provider database and Network operations.
Regularly scheduled reports related to Network status
Mailing label extract generation to support provider on-boarding
Generates provider related reports in support of provider contracting and provider relationship management
Other ad hoc provider reports as requested
Develops and maintains policies and procedures needed for the ongoing maintenance of the provider database.
Develops and documents audit mechanisms to support the management of provider network changes, additions and terminations to ensure provider data accuracy.
Perform related duties as assigned
* ADA Essential Functions
EXPERIENCE AND QUALIFICATIONS
Bachelor’s Degree in Information Technology, Business Administration or related field, required.
Minimum of two (2) years related data analytics and report-writing experience in managed care or healthcare, required. Experience with QNXT, SQL, Crystal Reports, preferred.
Knowledge of Government Health Programs (Medicaid and Medicare).
Knowledge of medical terminology, CPT, ICD-9 codes, required.
Proficiency in Microsoft Access and Excel, required.