Note: The job is a remote job and is open to candidates in USA. Altais is a healthcare organization focused on improving the healthcare experience for physicians and patients through smarter technology, purpose-built tools, and team-based care. The Provider Data Management Data Analyst analyzes, maintains, and validates provider data for credentialing and health plan roster creation, while supporting reporting, audits, compliance, data quality, and process improvement initiatives.
Responsibilities
- Analyze provider data to identify inaccuracies, missing information, duplicates, and inconsistencies
- Perform data validation, reconciliation, and quality assurance across multiple systems
- Review provider demographic, specialty, affiliation, licensure, credentialing, and participation information
- Track data-quality trends and recommend corrective actions
- Maintain data standards, definitions, procedures, and documentation
- Support provider onboarding, recredentialing, updates, and terminations
- Review credentialing data for completeness and alignment with organizational policies
- Validate licenses, certifications, specialties, malpractice coverage, affiliations, and other credentialing elements
- Identify credential expirations, missing documentation, and records requiring remediation
- Partner with credentialing teams to improve data accuracy and operational efficiency
- Support compliance with applicable state requirements, CMS guidance, and accreditation standards
- Create and maintain provider rosters for submission to health plans and other external partners
- Extract, transform, format, and validate provider data according to payer-specific requirements
- Confirm roster accuracy for demographics, specialties, products, locations, affiliations, provider identifiers, and participation status
- Perform pre-submission quality checks and resolve exceptions before delivery
- Reconcile submitted rosters with source systems and health plan feedback
- Coordinate corrections, resubmissions, and status updates within established turnaround times
- Maintain roster templates, submission schedules, version controls, and applicable payer documentation
- Develop recurring and ad hoc reports related to credentialing status, roster accuracy, data completeness, and operational performance
- Monitor key performance indicators, such as data error rates, roster turnaround time, rejected records, and credentialing timeliness
- Use Excel, SQL, Power BI, or other analytical tools to transform data into actionable insights
- Document analytical methods, assumptions, exceptions, and findings
- Present results and recommendations to business partners and leadership
- Collaborate with credentialing, provider operations, contracting, network management, compliance, enrollment, and IT teams
- Serve as a subject matter expert for credentialing data and roster processes
- Communicate data issues, business impacts, and recommended resolutions clearly
- Support testing and validation for system enhancements, integrations, and process changes
- Assist with internal, health plan, and regulatory audits
- Identify opportunities to streamline roster creation, validation, and reconciliation processes
- Support automation and workflow-improvement initiatives
- Establish repeatable controls for data accuracy, completeness, and timely submission
- Maintain version-controlled process documentation and standard operating procedures
- Promote consistent data governance practices across provider data workflows
Skills
- Bachelor's degree in Health Administration, Data Analytics, Business, Information Systems, or a related field, or equivalent experience
- Three or more years of experience in healthcare data analysis, provider data management, credentialing, provider enrollment, or a related discipline
- Experience working with provider data elements, including NPI, taxonomy, licensure, specialties, practice locations, and health plan participation
- Experience creating, validating, and submitting provider rosters
- Advanced proficiency in Microsoft Excel, including pivot tables, lookups, filtering, and data reconciliation
- Strong analytical, organizational, and problem-solving skills
- High attention to detail and ability to manage competing deadlines
Benefits
- Excellent medical, vision, and dental coverage
- 401k savings plan with a company match
- Flexible time off and 9 Paid Holidays
- Eligible to participate in the annual bonus program
Company Overview
Company H1B Sponsorship