Data Analyst - Compliance
Company: Providence Health & Services
Posted on: August 5, 2022
Data Analyst - Compliance $1,000 Sign-On Bonus
$1,000 Sign-On Bonus for eligible external hires that meet required
qualifications and conditions for payment.
Location: Anaheim, CA
Schedule: Full time - 80 Biweekly Hours
Shift: 8-hour, Days
The Data Analyst for Regulatory Compliance Reporting Analyst will
compile and analyze reports for submission for the Health Plan
Audits for their respective Product Lines (Commercial, Senior, and
Medical) which impact 10 Health Plans. This position will support
internal department reporting needs to fulfill business
requirements. This role has strong interaction and collaboration
across SJHH NSS and Care Integration (NSS Support Services, Claims,
Claims Auditing, UM, and CM) operations. In addition, this position
provides reports to a variety of customers, both internal and
external on a regular basis. Reports will include UM reporting
activities, Provider Dispute Resolution, Re-Opening for Senior
Claims, FEHBP, Claims Inventory, Misdirected Claims, Medicare
Interest Rate and Claims Pricing, MTR, Monthly NSS, Board
Foundation, and Regional Report. Manage the flow of scheduled
reports to ensure customer deadlines and health plan audit
compliance requirements are met.
- Associate's Degree, or High School Diploma/GED with 2 years
relevant experience in field directly related to reporting and data
- 1 year Experience compiling reports in a Healthcare related
business, preferably in a health plan environment.
- 1 year Experience supporting users with reporting
- 1 year Audit and compliance experience.
- Recent experience working with Claims and Utilization
Management related data.
- Experience with HIPAA Regulation and California State Law.
- Bachelor's Degree
- 2 years Experience compiling reports in a Healthcare related
business in a health plan environment.
- 2 years Experience supporting users with reporting
- 2 years Experience in a healthcare organization working with
health plan or government regulations.
- 2 years Audit and compliance experience.
- Recent experience working with Claims or Utilization Management
related data in the Medicare, Medical or Commercial healthcare
Our best-in-class benefits
uniquely designed to support you and your family in staying well,
growing professionally, and achieving financial security. We take
care of you, so you can focus on delivering our Mission
caring for everyone, especially the most vulnerable in our
Providence Medical Foundation (formerly St. Joseph Heritage Health)
includes seven medical groups throughout Northern California,
Orange County, High Desert and Los Angeles County. With 175
locations and nearly 4,000 caregivers (employees), Providence
Medical Foundation has been continually recognized as a leader in
quality, receiving top honors from various organizations, including
the Orange County Medical Association for Physicians of Excellence
and the Integrated Healthcare Association with distinction in
clinical quality. Providence Medical Foundation provides equal
employment opportunities (EEO) to all employees and applicants for
employment without regard to race, color, religion, sex, national
origin, age, disability or genetics. In addition to federal law
requirements, Providence Medical Foundation complies with
applicable state and local laws governing nondiscrimination in
employment in every location in which the company has facilities.
This policy applies to all terms and conditions of employment,
including recruiting, hiring, placement, promotion, termination,
layoff, recall, transfer, leaves of absence, compensation and
Company: Providence Medical Foundation
Category: Analytics/ Business Intelligence
Req ID: R363103
Keywords: Providence Health & Services, Anaheim , Data Analyst - Compliance, Professions , Anaheim, California
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