Business Analyst Provider Data Management

We are seeking a Business Analyst for Provider Data Management to join our team at Independent Living Systems (ILS). ILS, along with its affiliated health plans known as Florida Community Care and Florida Complete Care, is committed to promoting a higher quality of life and maximizing independence for all vulnerable populations.

About the Role:

The Business Analyst for Provider Data Management plays a critical role in ensuring the accuracy, integrity, and completeness of provider data within the organization. This position is responsible for analyzing, documenting, and improving data management processes to support operational efficiency and regulatory compliance. The role involves collaborating with cross-functional teams to identify data quality issues, develop solutions, and implement best practices for provider data management. The Business Analyst will also support reporting and analytics efforts by translating business needs into technical requirements and facilitating communication between stakeholders and IT teams. Ultimately, this position drives the continuous improvement of provider data systems to enhance decision-making and support strategic business objectives.

Minimum Qualifications:

• Associate's degree in Business Administration, Information Systems, Healthcare Administration, or a related field.
• 3+ years of experience in business analysis, preferably within healthcare or provider data management.
• Familiarity and understanding of provider contracts. 
• Proficient knowledge of UB04 / CMS-1500 claim adjudication process, including Medicare and Medicaid reimbursement methodologies 

Preferred Qualifications:

• Bachelor’s degree in Business Administration, Information Systems, Healthcare Administration, or a related field.
• Experience with healthcare provider data systems such as CAQH, NPPES, or similar platforms.
• Familiarity with healthcare regulations and compliance requirements related to provider data.
• Knowledge of SQL and data visualization tools like Tableau or Power BI.
• Certification in Business Analysis (e.g., CBAP, CCBA) or related credentials.
• Experience working in Agile or Scrum project environments.

Responsibilities:

• Analyze and document current provider data management processes and identify areas for improvement.
• Collaborate with stakeholders across departments to gather and validate business requirements related to provider data.
• Develop and maintain detailed functional specifications and process documentation.
• Support data quality initiatives by identifying discrepancies, coordinating data cleansing efforts, and monitoring data accuracy.
• Work closely with IT and data teams to translate business requirements into technical solutions and ensure successful implementation.
• Facilitate communication between business users and technical teams to resolve issues and optimize data workflows.
• Assist in the development and delivery of training materials and user guides related to provider data management systems.
• Generate and analyze reports to track data quality metrics and support compliance with regulatory standards.