Healthcare Reporting Analyst I

Overview

This role supports enterprise reporting needs by preparing, analyzing, and reporting key financial and revenue cycle management (RCM) information through standard and ad hoc reports. Responsibilities include auditing and validating provider roster data from contracted commercial health plans to ensure accuracy and alignment with contract requirements, value-based initiatives, and service level requirements (SLRs).

This position involves remote work during assigned hours:

• 8:00 a.m. – 5:00 p.m. or 7:00 a.m. – 4:00 p.m.

To be considered, candidates must reside in Ohio, Florida or Nevada.

Responsibilities

• Prepare, analyze, and communicate key financial information; provide support to management and other staff regarding financial reporting and related issues.
• Support budget preparation and financial planning processes, including budget review for compliance and opportunities.
• Audit and validate provider roster data from contracted commercial health plans for alignment with contract requirements, value-based initiatives, and SLRs.
• Compare health plan data against internal provider databases and identify discrepancies, including:
  • Provider demographics
  • Credentialing
  • Enrollment status
  • Practice locations
  • Provider assignments
• Collaborate with health plans to resolve data quality issues.
• Monitor and trend roster errors.
• Validate provider attribution for value-based care and risk contracts.
• Support new health plan implementations through roster audits and quality assurance reviews.
• Use advanced Excel skills to analyze large datasets, develop reporting requirements, validate reporting outputs, and support data quality initiatives.
• Partner with database developers and the Network Data & Reporting team on data quality initiatives.
• Use AI tools (such as Copilot and ChatGPT) to improve reporting efficiency and documentation while investigating provider data issues that may affect:
  • Claims processing
  • Reimbursement
  • Authorizations
  • Network participation
  • Patient access to care.
• Complete special projects, including necessary research, forecasting, and conflict resolution.
• Perform other duties as assigned.

Requirements (Minimum Qualifications)

• Bachelor’s Degree in Accounting, Finance, Business or a related field
  OR Associate’s Degree and two years of experience
  OR High School Diploma/GED and four years of experience
• Ability to complete basic analytical, consultative, and information support through analysis and report preparation.
• Awareness of key performance indicators, cash flow analysis, product line analysis, and proposal development.

Preferred Qualifications

• One year of Accounting, Finance, Healthcare, Investment Banking or Management Consulting experience
• Certified Public Accountant (CPA) or Certified Management Account (CMA) certification
• Familiar with SQL coding or backend system relationships
• Experience with tools such as Microsoft Copilot, ChatGPT, Epic's Coco, and Snowflake-related AI capabilities
• Advanced Excel proficiency (conditional formatting, pivot tables, formulas, VLOOKUP)
• Credentialing experience
• Professional experience working with provider enrollment, credentialing, provider rosters, provider demographics, or provider directory data within a healthcare organization or health plan

Physical Requirements

• Ability to communicate and exchange accurate information.
• Ability to perform work in a stationary position for extended periods.
• Ability to work with physical records or operate a computer or other office equipment.
• In some locations, ability to travel throughout the hospital system.
• In some locations, ability to move up to 25 lbs.

Personal Protective Equipment (PPE)

• Follows Standard Precautions using personal protective equipment as required for procedures.

Pay Range

• Minimum Annual Salary: $43,200.00
• Maximum Annual Salary: $65,880.00

The pay range reflects the anticipated range for new hires. Actual compensation will be determined based on factors such as work history, experience, skill set, and education. The pay range does not include applicable pay practices (e.g., shift differentials, overtime). It also does not include the value of the benefits package (e.g., healthcare, dental and vision benefits, retirement savings account contributions, etc.).

Location

Remote work from within Ohio, Florida or Nevada.