Provider Data Contract Accuracy Analyst

Published date Posted on Indeed on Jan 15, 2022 (10 d ago)

Role Summary:

AllyAlign Health (www.allyalign.com) is a rapidly growing organization focused on revolutionizing the long-term healthcare ecosystem for the benefit of our members, provider and payer partners. Our unique approach to managing care delivery and proactively partnering with healthcare providers has enabled us to achieve industry leading health outcomes for our members. AllyAlign Health has partnered with several Nursing Home companies to form Institutional Special Needs Plans (I-SNPS), which are a form of Medicare Advantage Plans.

In this model, AllyAlign is responsible for administering the health plans, providing shared services such as member enrollment, call center, claims processing, authorization processing, financial services, compliance services and grievance and appeals administration. AllyAlign has grown very aggressively and is working to expand our operational capacity and capability.

AllyAlign Health is looking for a qualified candidate to support provider data accuracy, as a Provider Data & Contract Accuracy Analyst. This role reports to the Director of Provider Network Management.

Job Summary:

This role will support the Provider Network Management team in all aspects of provider data quality and system updates. This role is a critical part of AllyAlign's operations and essential to our ability to maintain accurate provider information, as well as our ability to expand our services to new geographical service areas. Utilize your expertise and ideas to shape the department and implement new processes as the team and organization expands.

Responsibilities:

  • Develop and implement data collection systems and other strategies that optimize statistical efficiency and data quality.
  • Manage mass provider data system updates to the Salesforce platform.
  • Assist with requirement writing, oversee provider data and claim management system updates and quality check those updates.
  • Create SQL queries, data dictionaries, and clinical alert rules in a version-controlled environment.
  • Create automated process to improve the way AAH internal provider data management systems interact with and transfer data to external 3rd party vendor platforms.
  • Conduct research related to inconsistent data loads as well as monitor data updates for multiple plans/clients.
  • Acquire data from primary or secondary data sources and maintain databases/data systems.
  • Locate and define new process improvement opportunities.
  • Work closely with management to prioritize business and information needs.
  • Work closely with external vendors and internal business/IT units to resolve any provider data quality issues.
  • Perform data analysis related to investigations and data quality control and evaluate data loads for accuracy and prepare defect documentation when needed.

Knowledge & Skills Required:

  • Due to the nature of our business, we require all of our employees to be fully vaccinated within 90 days of their start date, in compliance with all applicable EEOC guidance regarding vaccines and qualified exemptions.
  • Minimum 5 years within a Managed Care environment and payor organization
  • Bachelor's Degree in Computer Science, Information Management or Information Technology
  • Minimum of 5 years' experience working with Microsoft SQL databases and query writing.
  • Knowledge of relational databases, database design, and data mining techniques
  • Experience with Salesforce & provider claim platforms preferred.
  • Strong understanding of Microsoft Excel and Microsoft Access tools
  • Ability to work with multiple data sets on cross-systems.
  • Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy.
  • Understanding of QA processes to assist in testing and implementing system updates and new client implementations.
  • Work independently, think strategically, and tactically implement while demonstrating strong flexibility.
  • Ability to work in a fast-paced environment, handle a heavy workload while fully engaging with internal and external stakeholders.
  • Results-oriented, self-motivated team player who is flexible and reliable.

Benefits:

  • Market competitive salary
  • Flexible PTO
  • 9 Paid Holidays per Year (7 fixed and 2 floating)
  • Medical Insurance
  • Dental Insurance benefits
  • Vision Insurance benefits
  • Health Savings Account contributions if you elect to participate in our Medical Insurance plan
  • Long-Term Disability / Short-Term Disability and Life Insurance
  • 401K Plan

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