Provider Data Lead Analyst - Evernorth - Remote

Position Summary

This role supports the Network Operations Quality Enablement Team within the Provider Solutions & Operations (PS&O) organization.This position will conduct quality audit activities that measure and analyze the quality and consumption of provider data along with partnering in process improvement initiatives.

Activities may include conducting focused audits, utilizing quality tools, analyzing root causes and performing analytical techniques.

This role will also identify defects and will contribute to pinpointing the causes and offer recommendations for prevention.

This role will maintain a strong focus on facts and data to understand the quality of our network, contracts, and demographics in Provider data.

This will require the ability to think critically and utilize judgment, fact and discretion in helping to drive quality improvements.

The Provider Data Lead Analyst should be proficient in understanding and interpreting provider data in source systems.

Excellent customer service and communication skills are also a requirement of the role.

This role uses various tools that assist with data validation and requires proficiency in working with data and basic data analysis.

This role requires a solid understanding of the importance of data accuracy, data analytics, and external provider group relationships.

A strategic mindset and ability to adapt to changing requirements and priorities is vital.

Duties Include:


* Engage with external provider partners by conducting outreach calls in a meaningful manner to improve and enhance the provider experience


* Track outgoing and incoming communication including documentation of outcome, key relational and field element changes


* Validate the demographic information and metadata of providers across the following data elements: Provider Status, Name, Gender, Date of Birth (DOB), State License, DEA, Address and Hospital Affiliation by web research and outbound calls to providers' offices.


* Validate the relational information of providers across the following data elements: Service Locations, Group Affiliation and Provider Practicing Status by making outbound calls to providers' offices.


* Assess the accuracy, completeness, and currency of Networks, Contracts, Demographic and Reimbursement data within Cigna systems.


* Implement and support business activities utilizing data mining, reporting, and other intelligence methods and tools.


* Submit provider updates to Provider Data Management (PDM) following existing outlined processes.


* Perform provider updates by automated processes and manual remediation.


* Excellent relationship building skills with internal and external partners.


* Accountable for supporting business readiness activities for project implementation.


* Assist with any special projects.

Requirements:


* High School Diploma or G.E.D.

required; Bachelor's degree preferred


* 3+ years of work experience in provider s...