Verda Healthcare, Inc. has a contract with the Center of Medicaid and Medicare Services (CMS) and Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are looking for an Operations Analyst to join our growing company with many internal opportunities.
Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare, Inc. is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.
Align your career goals with Verda Healthcare, Inc. and we will support you all the way.
Position Overview
The Operations Analyst is responsible for accurate and timely maintenance of provider information across all provider databases and systems, and continuously validating the data to ensure adherence to business and system requirements of customers as it pertains to contracting, network management, and credentialing.
Responsibilities:
- Timely and accurate maintenance of provider information on all health plan systems, databases, and directories.
- Utilize industry standard sources and best practices to audit and remediate provider data accuracy and quality concerns.
- Perform routine updates to provider data across all internal systems and ensure data synchronization.
- Continuously maintain and audit provider data to ensure quality and accuracy of provider directory information across systems.
- Generate and distribute scheduled reports in accordance with departmental/business requirements. • Prepare ad-hoc reports as needed for other internal areas (e.g., Provider Services, Member
Experience, Claims).
- Assist with enhancements to databases, data collection systems, data analytics and other strategies that optimize statistical efficiency and quality.
- Work collaboratively across the organization to address business needs, determine configuration changes needed and how the changes impact other areas.
- Participates in regular internal and external compliance audits related to provider data. • Troubleshoot and resolve data-related issues.
- Stay up-to-date on industry best practices, new developments in Provider information exchange, and emerging regulatory and standards-based legislation.
Minimum Qualifications
- Associates degree required
- Bachelor’s degree preferred in Management Information Systems, Healthcare Administration or related field
- 1+ years’ experience in provider data management, provider configuration/benefits maintenance, and/or medical data processing.
Professional Competencies
- Proficient in Microsoft Suite (Excel, PowerPoint, Project, Outlook, Word, Visio, etc.).
- Prior experience within a health plan, IPA or large provider organization setting preferred.
- Demonstrates analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy.
- Moderate/Advanced expertise with Excel preferred
- Experience with Microsoft database tools, including Power BI, preferred
- Ability to manage and prioritize multiple tasks, promote teamwork and fact-based decision making. • Demonstrated communication capabilities including presentations, working sessions, and training. • Desire to join a fast paced, start-up culture and be a contributor to its growth and expansion.
Verda cares deeply about the future, growth, and well-being of its employees. Join our team today!
Job Type: Full-time
Benefits:
- 401(k)
- Paid time off
- Health insurance • Dental Insurance • Vision insurance • Life insurance
Schedule:
- Full-time onsite
- Standard business hours Monday to Friday/weekends as needed
- Occasional travel may be required for meetings and training sessions.
Ability to commute/relocate:
- Reliably commute or planning to relocate before starting work (Required)
PHYSICAL DEMANDS
Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.
*Other duties may be assigned in support of departmental goals