Provider Data Analyst II

Job Title: Provider Data Management Analyst II

Location: : Remote in GA

Work Arrangement: Remote (GA)

Employment Type: Contract

Duration: : 6 Months with the possibility of extension

Domain: Provider Data

Pay Rate: $35-$40/hr W2

Application Deadline: Last date for receipt of applications Oct 20, 2026

Qualifications:

• Seeking a strong, analytical Business Analyst II who can quickly learn complex processes, independently analyze data, identify root causes and process gaps, and drive issues through resolution.
• Looking for someone who is highly detail-oriented, solutions-focused, comfortable working with large datasets and reporting tools, and able to effectively communicate findings and recommendations to both business and technical stakeholders. Healthcare/provider data experience is a plus.

Education/Certification Required:

• Bachelor’s degree in a related field, or Associate’s degree in related field or equivalent experience and 2+ years of provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care, insurance, or medical office environment.
• Experience performing data analysis in Excel or similar tools strongly preferred.

Years of experience required:

• Bachelor’s degree in a related field, or associate’s degree in related field or equivalent experience and 2+ years of provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in managed care, insurance, or medical office environment.
• Experience performing data analysis in Excel or similar tools is highly preferred.

Must-have skills:

• Xcel, systems savvy etc.
• quickly learn complex processes
• identify root causes and process gaps, and drive issues through resolution

Job Description:

Story Behind the Need

• Provider Data Management is responsible for ensuring provider information is accurate, complete, and loaded timely across all health plan systems. The team supports provider enrollment, demographics, contract affiliations, terminations, directory accuracy, compliance requirements, and provider data maintenance activities that directly impact claims processing, provider network management, and member access to care.
• This request is being driven by a combination of workload demands, business growth, VSP and resource capacity needs.
• The Provider Data Management team operates in a collaborative, fast-paced environment focused on accuracy, quality, and customer service. Team members work closely with Contracting, Credentialing, Configuration, Network Management, Compliance, and other operational business partners to ensure provider records are maintained correctly and efficiently. The team values cross-training, continuous learning, process improvement, teamwork, and accountability.

Key responsibilities and projects include:

• Provider enrollment and maintenance
• Provider roster processing
• Data quality and validation reviews
• Provider directory accuracy
• Network adequacy support
• WellCare and Medicare provider data initiatives
• Large-scale provider updates and implementations
• Regulatory and compliance-related provider data activities
• Process improvement and automation opportunities

Currently, this request supports current operational and staffing needs within Provider Data Management.

Additional hiring needs may be evaluated based on workload volume, future business initiatives, staff transitions, and project demands. This position will also help support operational stability and provide flexibility for upcoming growth opportunities and business priorities.

Typical Day in the Role:

• The Provider Data Management (PDM) team is responsible for maintaining accurate provider data across multiple systems to support provider participation, claims payment, directory accuracy, compliance, and member access to care.
• Daily responsibilities typically include:
• Reviewing and processing provider enrollment, demographic, affiliation, and termination requests.
• Researching and resolving provider data discrepancies.
• Working provider rosters and large-scale provider update projects.
• Validating provider information before loading or updating records.
• Collaborating with Contracting, Credentialing, Configuration, Network Management, and Health Plan partners.
• Investigating and resolving inventory items, escalations, and aging work queues.
• Performing quality reviews and post-load validation to ensure data accuracy.
• Supporting provider directory accuracy and network adequacy initiatives.
• Participating in project work related to provider data implementations, regulatory requirements, system enhancements, and process improvements.
• The current project work is focused on maintaining accurate provider data while supporting ongoing business initiatives, roster processing, provider maintenance activities, directory reviews, and health plan operational priorities.

Performance is generally measured by:

• Productivity and timely completion of assigned inventory.
• Adherence to service level agreements (SLAs) and turnaround times.
• Accuracy and quality of provider data updates.
• Quality audit results and error rates.
• Ability to manage aging inventory and meet deadlines.
• Compliance with established processes and documentation requirements.
• Collaboration and responsiveness with business partners and providers.
• Participation in cross-training and continuous improvement efforts.
• This role offers a unique opportunity to work at the center of provider operations. Provider data serves as the foundation for many critical business functions including provider directories, claims processing, network adequacy, credentialing, member attribution, and regulatory compliance. Errors or delays in provider data can directly impact providers, members, and health plan operations.

BENEFITS:

Medical | Dental | Vision | 401(k)

EEOC Compliance:

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment.

DISCLAIMER

AI Usage Policy: Pacer Group uses AI to assist in screening applications. Final hiring decisions are made by human recruiters based on qualifications and experience.