Job Description:
• Lead attribution, membership, and provider data governance processes to ensure accurate and reliable operational outputs.
• Oversee resolution of provider data and attribution issues that affect member assignment, reporting accuracy, and downstream operations.
• Partners with health plan leaders, network teams, provider data teams, claims, compliance, marketing, operations, and technology partners to deliver projects that support business performance, regulatory requirements, and customer experience.
• Support provider directory accuracy, audit readiness, and regulatory validation activities through monitoring, documentation, and issue remediation.
• Identify recurring defects, root causes, and control gaps, then drive process improvements that reduce rework and improve operational reliability.
• Maintain governance routines, process documentation, and cross-functional coordination for attribution and provider data operations.
Requirements:
• 5+ years of experience in Medicaid, managed care operations, provider data, healthcare analytics.
• SQL, advanced Excel, Power BI, Tableau, or similar tools
• Investigating data quality and reporting issues, identifying root causes, and communicating findings to stakeholders
• Experience managing provider data, directory accuracy, or related operational issues across multiple teams.
• Strong communication skills, including the ability to translate complex operational issues into clear business risk, action plans, and ownership.
Benefits:
• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility