AmeriHealth Caritas · 16 hours ago
Provider Network Operations Data Analyst
Southfield, MI
Full-time
Hybrid
Entry Level
1+ years expAmeriHealth Caritas is a health plan provider focused on Medicaid, Medicare, and Exchange products. The Provider Network Operations Data Analyst plays a key role in maintaining accurate provider data and fostering relationships with providers, ensuring that provider information is correctly represented and issues are resolved efficiently.
Health CareInformation Technology
Responsibilities
Serve as a primary point of contact for providers, ensuring timely resolution of inquiries and issues
Communicate plan policies, procedures, and regulatory updates clearly and professionally
Maintain and monitor provider data to ensure accuracy across all systems
Review and process provider data intake forms for completeness
Track and document provider data changes to ensure timely updates and compliance with turnaround standards
Escalate discrepancies or requests that conflict with business processes or contract terms
Ensure timely and accurate management of provider contracts, including terms and reimbursement details
Investigate and respond to member complaints within established timelines
Identify and report compliance issues in accordance with plan policies and procedures
Demonstrate working knowledge of provider databases (e.g., Facets) and reimbursement methodologies
Collaborate with internal departments to manage medical costs and support strategic initiatives
Demonstrates working knowledge of Facets, particularly the provider database, and consistently communicates updates, such as additions, deletions, or corrections, to the provider maintenance department
Qualification
Required
Bachelor's degree or equivalent work experience required
At least one year of experience working with healthcare providers and provider relations
Proficiency in Microsoft Excel & Access (formulas, pivot tables, charts/graphs)
Strong analytical skills (non-IT focused)
Preferred
3 years of experience in managed care or health insurance preferred
Company
AmeriHealth Caritas
AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.
10001+ employees
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)
Funding
Current Stage
Late StageLeadership Team
Kathleen Giblin
SVP Clinical Operations
Ash Hanson
Executive Vice President & Chief Human Resources Officer
Recent News
2025-11-06
The Philadelphia Inquirer
2025-10-02
2025-10-01
Company data provided by crunchbase