Virginia Premier Health Plan Data Quality Analyst II in Richmond, Virginia

About Us

Don’t just find a job, find your WHY at a purpose-driven organization; discover a career at Virginia Premier.

By blending quality benefits, affiliating with the world-renowned VCU Health System and offering career-advancing development programs, we allow our employees to focus on the meaningful work of improving and saving the lives of more than 200,000 people throughout the state of Virginia.

At Virginia Premier, we are building an industry leading health care organization through dedicated teams that have heart, provide top-notch quality member services and embrace our mission of inspiring healthy living within the communities we serve. Our vision is to connect people to innovation, quality and affordable health care for all phases of life.

If this sounds like you, read on!

Overview

This position is primarily responsible for assisting the Manager of Analytics with all activities relating to Network Development data quality, including maintaining and analyzing data integrity to adhere to all requirements under the CMS and DMAS program.

Responsibilities

  • Ensure Network Development Department adheres to the guidelines set forth by accreditation and regulatory organizations (i.e. NCQA, DMAS).

  • Coordinates resolution of problems with the state of Virginia, Centers for Medicare and Medicaid and related regulatory organizations.

  • Helps coordinate internal compliance data audits for the department.

  • Develops and maintains Network Development data quality metrics and TAT reports

  • Assists with the data auditing functions related to provider data and vendor set up through internal reporting tools.

  • Researching and reporting data quality issues and develop process for data improvement

  • Coordinates both departmental and interdepartmental resolution of data quality issues identified

  • Assists Provider Data, Provider Services and Contracting staff in researching and resolving provider setup and data issues

Qualifications

MINIMUM EDUCATION REQUIREMENTS

  • Four (4) year college degree from an accredited institution required

  • Business, Finance, Economics, Statistics, Mathematics, Information Systems or related field preferred

SPECIAL KNOWLEDGE AND/OR SKILLS

  • Strong analytical and technical skills

  • Openly and actively communicates information and takes initiative to communicate

  • Handles difficult situations diplomatically

  • Ability to build strong interdepartmental relationships

  • Project management, time management and organizational skills

WORK BACKGROUND/EXPERIENCE

  • 1 year experience using Excel, SQL required

  • Experience in an analytical capacity preferred

  • Experience using BI tools (Tableau, QlikView and Microsoft Power BI) preferred

  • Previous experience in healthcare helpful

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

Our mission is to inspire healthy living within the communities we serve!

Job ID 2018-5345

As an equal opportunity employer, Virginia Premier is committed to a diverse workforce. To ensure non-discrimination and affirmative action for individuals protected by Executive Order 11246, as amended, Section 503 of the Rehabilitation Act of 1973, as amended, the Vietnam Veterans’ Readjustment Act of 1974, as amended, and Title I of the Americans with Disabilities Act of 1990, as amended, Virginia Premier will consider applicants for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. Applicants who require accommodation in the job application process may contact Recruitment at 804-819-5151 for assistance. It is the policy of Virginia Premier Health Plan, Inc., to comply with the requirements of the Drug-Free Workplace Act of 1988. It is a violation of our drug-free workplace policy to use, possess, sell, trade, and/or offer for sale alcohol, illegal drugs or intoxicants in our workplace. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. Virginia Premier participates in E-verify.