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Data Analyst - Compliance

Company: Providence Health & Services
Location: Anaheim
Posted on: August 5, 2022

Job Description:

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.







Required qualifications:



  • Associate's Degree, or High School Diploma/GED with 2 years relevant experience in field directly related to reporting and data analysis.

  • 1 year Experience compiling reports in a Healthcare related business, preferably in a health plan environment.

  • 1 year Experience supporting users with reporting requirements.

  • 1 year Audit and compliance experience.

  • Recent experience working with Claims and Utilization Management related data.

  • Experience with HIPAA Regulation and California State Law.









    Preferred qualifications:



    • 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 requirements.

    • 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 environment.













      Our best-in-class benefits (https://www.providenceiscalling.jobs/rewards-benefits/) are 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 (https://www.providenceiscalling.jobs/mission-core-values/) of caring for everyone, especially the most vulnerable in our communities.



      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 training.

      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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