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AmeriHealth Caritas · 1 month ago

Provider Network Data Oversight Analyst

Newtown Square, PA

Full-time

Hybrid

Mid Level

4+ years exp

AmeriHealth Caritas is a mission-driven organization focused on delivering comprehensive healthcare solutions. The Provider Network Data Oversight Analyst is responsible for oversight and validation of payment terms data, managing multiple projects, and providing analytical support to the Provider Network Management team.

Health CareInformation Technology

H1B Sponsor Likely

Responsibilities

Collaborates with Actuarial, Network, and Operational areas to develop lenses that provide event triggered output for monitoring of impending contract changes and provider patterns

Effectively prioritizes and communicates insights and recommendations

Facilitates partnerships with Vendors, IT, Payment Systems, Operations Services, Provider Network Management, Market, and Clinical teams as needed to research financial issues, risks, and opportunities related to fee schedules, chargemasters, contract terms, and outliers

Manages issue-tracking database to ensure that challenges are resolved within established timeframes and escalates open issues as needed

Defines, develops, and/or implements data modeling tools or reports designed to routinely assess and support existing and new provider network management processes, programs, contract performance, and proposed initiatives, such as fee schedule development, provider contract interpretation’ and system interfaces/integration

Qualification

Advanced Microsoft ExcelSQLBI ToolsData modelingDatabricksSASPythonRCommunication skillsProblem-solving

Required

Bachelor's Degree required

At least four (4) years of Analytics experience

Advanced Microsoft Excel experience required

Experience with SQL and BI Tools such as Power BI or Tableau required

Superior analytical skills including the use of very large data sets; ability to recognize anomalies in findings, and pursue and/or recommend resolution

Ability to work with integrated data from multiple sources

Other relevant experience includes work with Databricks, SAS, Python, and R

Demonstrated ability in effectively interfacing with key leaders and stakeholders both internal and external to the organization to research technical and/or operational issues and define solutions

Must have excellent communication skills

Benefits

Flexible work solutions including remote options

Hybrid work schedules

Competitive pay

Paid time off including holidays and volunteer events

Health insurance coverage for you and your dependents on Day 1

401(k)

Tuition reimbursement

Company

AmeriHealth Caritas

Glassdoor3.4

AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.

Founded in 1982

Philadelphia, Pennsylvania, USA

10001+ employees

http://www.amerihealthcaritas.com

H1B Sponsorship

AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (18)

2024 (17)

2023 (12)

2022 (14)

2021 (4)

2020 (11)