| Location | Remote-GA, GA (Remote) |
Position Purpose: Perform provider data management related activities based on plan and contract specifications and standard business rules includes data analysis and entry, review of data via internet sites and other systems, and usage of multiple systems and applications to validate data is complete and accurate. Education/Experience: Associate s degree, or high school diploma/equivalent and 1+ years of data entry, analysis or customer service experience, preferably with healthcare operations (i.e. claims processing, billing, provider relations or contracting), provider data management, or credentialing in a managed care, insurance, or medical office environment. Experience performing data analysis in Excel or similar tools strongly preferred. " Enroll providers and practitioners into the provider data management system " Update provider and practitioners with claims payment and directory information " Research, review, and make updates within the provider data management system per provider requests " Perform quality service checks on systemic data, inclusive of claims processing and provider directory information " Perform research and resolve problems as necessary | ||||||
| Story Behind the Need | ||||||
| This is a capacity/staffing need driven by workload and the need for analytical expertise. What is the purpose of this team? The Provider Data Management (PDM) team is responsible for maintaining accurate provider data across systems, supporting provider directory accuracy, managing provider data changes, and ensuring data integrity and regulatory compliance. The team partners with internal business, technical, network, claims, credentialing, and delegated entities to resolve provider data issues and improve processes. What is driving this need? This request is driven by workload demands and the need for additional analytical support within PDM. The team requires additional capacity to support data quality initiatives, reporting, data validation, and process improvement efforts. The resource will assist with analyzing data, identifying discrepancies, researching issues, and supporting timely resolution. This temporary position is intended to provide immediate support, with the potential to transition to a permanent role based on business needs and performance. Describe the surrounding team (team culture, work environment, etc.) & key projects. PDM is a collaborative, fast-paced team that supports multiple lines of business and partners closely with business and technical teams. The team values accountability, attention to detail, problem-solving, continuous improvement, and collaboration. Key responsibilities and projects include provider data quality and validation, provider directory accuracy, data analysis and reporting, system and process enhancements, delegated provider data management, and initiatives focused on improving operational efficiency and reducing rework. The ideal candidate will be eager to learn, receptive to coaching, and comfortable working with data in a deadline-driven environment. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative? This request is a backfill for a VSP position within the PDM team. | |||||
| Typical Day in the Role | ||||||
| 1. Walk me through the day-to-day responsibilities and a description of the project (outside of the Workday JD). The Business Analyst I will support Provider Data Management (PDM) through data analysis, research, validation, reporting, and process improvement initiatives. Day-to-day responsibilities include reviewing data for accuracy, identifying discrepancies, researching potential issues, assisting with root-cause analysis, preparing reports, and supporting the validation of system updates. The role will partner with team members and other departments to investigate provider data issues, improve data quality, reduce rework, and support ongoing operational initiatives. The ideal candidate will be analytical, detail-oriented, and eager to learn PDM processes and systems. 2. What are the performance expectations/metrics? Performance will be measured by the accuracy and quality of work, timely completion of assignments, attention to detail, and ability to follow established processes and meet deadlines. Additional expectations include identifying and communicating data discrepancies, conducting thorough research, maintaining accurate documentation, and incorporating feedback to improve performance. The candidate should demonstrate a willingness to learn new systems and processes, collaborate effectively with team members, manage assigned priorities, and contribute to reducing errors and rework. 3. What makes this role unique? This role offers an opportunity to apply analytical skills while learning the complexities of provider data management within a healthcare environment. The position combines data analysis, research, problem-solving, and operational support, with exposure to multiple systems, business processes, and cross-functional partnerships. The ideal candidate will be curious, detail-oriented, receptive to coaching, and comfortable working with data to identify discrepancies and support solutions. Experience with Excel, reporting tools, SQL, healthcare data, or provider operations is a plus, but the ability to learn, think critically, and adapt to changing priorities is equally important. | |||||
| Candidate Requirements: Seeking a strong, analytical Business Analyst II who can quickly learn complex processes, independently analyze data, identify root causes and process gaps, and drive issues through resolution. Looking for someone who is highly detail-oriented, solutions-focused, comfortable working with large datasets and reporting tools, and able to effectively communicate findings and recommendations to both business and technical stakeholders. Healthcare/provider data experience is a plus. | ||||||
| Education/Certification | Required: Bachelor s degree in a related field; or an associate degree in a related field with 2+ years of relevant experience; or an equivalent combination of education and experience. Experience in provider data management, credentialing, healthcare operations, claims processing, billing, provider relations, or contracting is preferred, particularly in a managed care, insurance, or medical office environment. Experience using Excel or similar tools to analyze data, validate information, identify discrepancies, or prepare reports is strongly preferred. | Preferred: | ||||
| Licensure | Required: N/A | Preferred: | ||||
| Disqualifiers: Additional qualities to look for: | ||||||
| 1 | Microsoft Excel and Data Analysis Ability to work with spreadsheets, organize and analyze data, use formulas and filters, identify discrepancies, and support data validation and reporting. | ||||
| 2 | Data Validation and Research Ability to review information across data sources, identify inconsistencies, research potential issues, and document findings accurately. | |||||
| 3 | Reporting and Data Tools Familiarity with reporting tools and the ability to learn systems used for data analysis and reporting. Experience with SQL, Power BI, or similar tools is a plus. | |||||
| Candidate Review & Selection | ||||||
| Projected Manager Candidate Review Date: | 1-2 days post shortlisting | ||||
Type of Interviews: | Teams, phone, etc. | |||||
| Required Testing or Assessment (by Vendor): | Typing test, basic computers skills test, etc. | |||||
| Next Steps | ||||||
| yes | |||||
| Pravi Gunaratne, Brandy Wilkes | |||||