Parkland Health · 9 hours ago
Provider Data Management Analyst- Health Plan
Dallas, TX
Full-time
Hybrid
Entry, Mid Level
2+ years expParkland Health is a community health plan focused on provider data management. The Provider Data Management Analyst is responsible for maintaining and updating provider data within the health plan's systems to ensure accuracy, compliance, and support for internal teams and regulatory requirements.
CommunitiesHealth CareHospitalMedicalNon ProfitWellness
Responsibilities
Ensure timely and accurate updates to provider data in systems, including provider demographic changes, terminations, and additions
Create and update documentation for provider data maintenance processes
Respond to inquiries related to provider data from internal teams, such as Claims, Operations, and Network/Provider Relations
Support the implementation of new processes and workflows for provider data maintenance
Integrate health literacy principles into all communication including Members and Providers
Support strategies that meet clinical, quality and network improvement goals
Promote the use of Health Information Technology to support and monitor the effectiveness of health and social interventions and make data-driven recommendations as needed
For staff in clinical roles, foster collaborative relationships with members and/or providers to promote and support evidence-based practices and care coordination
Perform regular audits of provider data to identify and resolve discrepancies or inaccuracies
Ensures work is carried out in compliance with regulatory and/or accreditation standards as well as contractual requirements
Assist with provider onboarding and credentialing processes, ensuring compliance with health plan policies
Collaborate with internal and external stakeholders to validate and maintain provider records in alignment with organizational policies and regulatory requirements
Generate and validate reports, including fall out reports for regulatory files such as Medicaid provider files and the MPF, ensuring compliance with state and federal guidelines
Promotes and supports a culturally welcoming and inclusive work environment
Acts with the highest integrity and ethical standards while adhering to Parkland's Mission, Vision, and Values
Adheres to organizational policies, procedures, and guidelines
Completes assigned training, self-appraisal, and annual health requirements timely
Adheres to hybrid work schedule requirements
Attends required meetings and town halls
Recognizes and communicates ethical and legal concerns through the established channels of communication
Demonstrates accountability and responsibility by independently completing work, including projects and assignments on time, and providing timely responses to requests for information
Maintains confidentiality at all times
Performs other work as requested that is reasonably related to the employee's position, qualifications, and competencies
Identifies ways to improve work processes and improve customer satisfaction. Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of PCHP
Stays abreast of the latest developments, advancements, and trends in the field by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices
Maintains knowledge of applicable rules, regulations, policies, laws and guidelines that impact the area. Develops effective internal controls designed to promote adherence with applicable laws, accreditation agency requirements, and customer requirements. Seeks advice and guidance as needed to ensure proper understanding
Qualification
Required
Bachelor's degree in healthcare administration, business administration, information systems, or a related field required
Two years of provider data management experience, including experience managing and submitting regulatory files, including Medicaid provider files and the Master Provider File (MPF), with an understanding of compliance requirements
Experience with QNXT or similar claims management & provider data systems required
Excellent verbal and written communication skills including the ability to communicate effectively and professionally across disciplines and cross functional teams
Ability to communicate complex information in understandable terms
Strong interpersonal and conflict resolution skills with the ability to establish and maintain effective working relationships across and beyond the organization
Excellent analytical, attention to detail, organizational, and problem-solving skills
Strong technical knowledge of healthcare configuration systems (e.g., QNXT)
Proficiency in data analysis and testing methodologies
Knowledge of regulatory compliance requirements for provider data and claims systems
Strong time management and organizational skills with the ability to manage multiple demands and respond to rapidly changing priorities
Ability to write clearly and succinctly with a high level of attention to detail
Proficient computer and Microsoft Office skills and other analytical tools
Ability to learn new software programs
Knowledge of Texas Medicaid, National Committee for Quality Assurance (NCQA), the Uniformed Managed Care Contract, and the Uniform Managed Care Manual
Company
Parkland Health
Parkland Health first opened its doors in 1894 and is now one of the largest public hospital systems in the country.
10001+ employees
H1B Sponsorship
Parkland Health 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 (2)
2024 (2)
2022 (2)
Funding
Current Stage
Late StageLeadership Team
Frederick Cerise
President and Chief Executive Officer
Richard Humphrey
Executive Vice President and Chief Financial Officer
Recent News
Company data provided by crunchbase