Provider Network Data Integrity Analyst (Remote within SHP Service Area)) in Marshfield, WI
Provider Network Data Integrity Analyst (Remote within SHP Service Area)) - Beaver Dam Community Hospital - Marshfield, WI - work from home job Company: Beaver Dam Community Hospital Job description: Come work at a place where innovation and teamwork come together to support the most exciting missions in the world! Job Title: Provider Network Data Integrity Analyst (Remote within SHP Service Area)) bolthires Center: 101651230 Payor Strat-Network Ctrcting Scheduled Weekly Hours: 40 Employee Type: Regular Work Shift: Mon-Fri; 8:00 am - 5:00 pm (United States of America) Job Description: JOB SUMMARY The Provider Network Data Integrity Analyst is responsible for the accuracy, completeness, and required regulatory filings of Security Health Plan’s (SHP) provider network. This individual serves as a resource for strategic planning, compliance, and network analysis. The Provider Network Data Integrity Analyst is responsible for completion of network adequacy filings for Centers for Medicare and Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), Department of Health Services (DHS), and requested employer groups. This individual is accountable for the maintenance, enhancements, and overall data integrity to ensure SHP’s provider directory meets established CMS standards. Position will work remotely. JOB QUALIFICATIONS EDUCATION For positions requiring education beyond a high school diploma or equivalent, educational qualifications must be from an institution whose accreditation is recognized by the Council for Higher Education and Accreditation. Minimum Required: Bachelor’s Degree in business administration, finance, healthcare related field, computer science, or analytics. Preferred/Optional: Successful completion of a post-secondary medical terminology course. EXPERIENCE Minimum Required: Three years’ experience in a medical group practice, health insurance or Health Maintenance Organization (HMO) environment. Demonstrated knowledge of data manipulation and analytical analysis. Proficiency with bolthires Office suite to include products, Excel and Access. Preferred/Optional: Understanding of geoaccess coding, provider credentialing, and medical terminology. CERTIFICATIONS/LICENSES The following licensure(s), certification(s), registration(s), etc., are required for this position. Licenses with restrictions are subject to review to determine if restrictions are substantially related to the position. Minimum Required: None Preferred/Optional: None Given employment and/or payroll requirements of individual states, Marshfield Clinic Health System supports remote work in the following states: Alabama Kentucky Oklahoma Alaska Michigan South Carolina Arkansas Minnesota South Dakota Florida Mississippi Tennessee Georgia Missouri Texas Idaho Nebraska Utah Illinois North Carolina West Virginia Indiana North Dakota Wisconsin Iowa Ohio Wyoming Kansas Marshfield Clinic Health System will not employ individuals living in states not listed above. Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. Successful applicants will listen, serve and put the needs of patients and customers first. At Marshfield Clinic Health System, we are fully committed to addressing health equity, diversity and inclusion for our employees and providers, our patients, and the communities we serve. We believe that every individual should have the opportunity to attain their highest level of health. We embrace diversity and welcome differences in who we are and how we think. We believe that any individual or group should feel welcomed, respected and valued. . Exclusion From Federal Programs: Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment. Employee must immediately notify his/her manager or the Health System’s Compliance Officer if he/she is threatened with exclusion or becomes excluded from any federally funded program. Marshfield Clinic Health System is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law. Provider Network Data Integrity Analyst (Remote within SHP Service Area)) - Beaver Dam Community Hospital - Marshfield, WI - work from home job Expected salary: Location: Marshfield, WI Provider Network Data Integrity Analyst (Remote within SHP Service Area)) - Beaver Dam Community Hospital - Marshfield, WI - work from home job Job date: Fri, 08 Sep 2023 06:23:51 GMT Apply for the job now! Provider Network Data Integrity Analyst (Remote within SHP Service Area)) - Beaver Dam Community Hospital - Marshfield, WI - work from home job Apply tot his job Apply tot his job Apply To this Job