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MedPOINT Management
Los Angeles, CA, United States
Job DescriptionJob Description Summary Under the general direction of Provider Network Operations (PNO) Project Manager, the Provider Directory Assurance Analyst is responsible for ensuring accurate, timely, and efficient reporting of Client IPA provider network data to the Health Plans, State or Federal entities. This position's primary function
Job Source: MedPOINT ManagementMedPOINT Management
Los Angeles, CA, United States
Job DescriptionJob Description Summary Under the general direction of Provider Network Operations (PNO) Project Manager, the Directory Data Assurance Analyst is responsible for ensuring accurate, timely, and efficient reporting of Client IPA provider network data to the Health Plans, State or Federal entities. This position's primary functions ar
Job Source: MedPOINT ManagementSouthern California Edison
Rosemead
Job Description **Join the Clean Energy Revolution** Become an **Environmental Assurance Advisor** in the Environmental Department at Southern California Edison (SCE) and build a better tomorrow. In this job, you’ll join the Environmental Risk and Assurance team responsible for maturing and implementing SCE’s ISO-14001 aligned environmental managem
Job Source: Southern California EdisonBlue Shield of California
Long Beach, CA, United States
Job Description Your Role The Communication Governance Provider Directory team is responsible for delivering Provider Directories to Blue Shield of California members in a timely and accurate manner. The Marketing Operations Principal, Communication Governance will report to the Senior Manager Implementation and Quality. In this role you will ove
Job Source: Blue Shield of CaliforniaTricorBraun Holdings
Cerritos, CA, United States
Quality Assurance Analyst page is loaded Quality Assurance Analyst Apply locations Cerritos, California time type Full time posted on Posted 4 Days Ago job requisition id R-100558 Make our quality assurance team your best move ever! We’re looking for a QA Analyst to help our customers solve any
Job Source: TricorBraun HoldingsClient of Reputable Staffing & Recruiting Firm
Cerritos, CA, United States
Job Description Job Description Brookwoods Group is working with a Global Packaging Solutions Company to identify a Quality Assurance Analyst. Quality Assurance Analyst role is a meticulous individual focused on supporting customers issues by ensuring the resolution of packaging quality issues. You must be able to identify and support opport
Job Source: Client of Reputable Staffing & Recruiting FirmTricorBraun
Cerritos, CA, United States
Make our quality assurance team your best move ever! We’re looking for a QA Analyst to help our customers solve any packaging quality issues. Why here ? TricorBraun is a global packaging leader, with team members working in locations throughout the Americas, Europe, Asia, Australia and New Zealand. As North America’s largest distributor of pri
Job Source: TricorBraunBrown & Brown Insurance
, CA, United States
Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Summary Creates and implements comprehensive software testing solutions for complex and diverse software systems with the primary focus being on increasing test coverage and test efficiency before an applicat
Job Source: Brown & Brown InsuranceLos Angeles, CA, United States
Job DescriptionJob Description
Summary
Under the general direction of Provider Network Operations (PNO) Project Manager, the Provider Directory Assurance Analyst is responsible for ensuring accurate, timely, and efficient reporting of Client IPA provider network data to the Health Plans, State or Federal entities. This position's primary functions are managing scheduled and ad-hoc reporting needs, troubleshooting data integrity issues and analyzing data. The Provider Directory Assurance Analyst will play a significant role in supporting the department's strategic goals.
Duties and Responsibilities
· Complete monthly, quarterly, semi-annual, annual Health Plan, State or Federal requested Provider Directory/Network validation Reports· Prepare Provider Network Reports for Hospital & Health Plans Ops, Utilization Management, Credentialing, and Compliance departments
· Work closely with the PNO Database and Network Management team to ensure reconciliation data received from the Health Plans are updated in the respective Client database
· Prepare Bi-Monthly Reports to aid in Provider Outreach efforts to maintain database accuracy
· Perform monthly quality assurance of Client databases to ensure compliance with regulatory requirements
· Communicate effectively with various internal departments to enhance cross-functional awareness, promote process improvements and identify issues
· Assist in various mandatory projects such as data cleanup, workflow revisions, and upkeep of maintenance
· Prepare ad-hoc reports as needed by MedPOINT or Client Leadership Teams
· Foster open lines of communication with Leadership on any network changes or issues
· Perform additional duties/assignments as needed
Minimum Job Requirements
· High School Diploma or GED required, Bachelor’s degree in healthcare, human services or related field preferred
· Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook)
· Access, SQL, SPSS knowledge, a plus
· EZ-CAP knowledge and experience, a plus
Skills and Abilities
· Proven ability to identify, analyze, and interpret trends or patterns in intermediate data sets
· Ability to multi-task, exercise excellent time management, and meet multiple deadlines
· Excellent attention to detail, with the ability to communicate and document information accurately
· Ability to work independently and take direction
· Ability to quickly learn and use new software tools
· Demonstrate commitment to the organization’s core values
· Ability to provide and receive constructive job-related feedback
· Communicates effectively and works well in a team
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Provider Directory Assurance Analyst- Hybrid jobs in Los Angeles, CA, United States
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