Provider Data Consultant
Company: VirtualVocations
Location: Vista
Posted on: May 24, 2025
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Job Description:
A company is looking for a Provider Data and Claims Consultant,
Remote.
Key Responsibilities
Support behavioral health member and provider operations through
pricing integrity audits and provider pick integrity programs
Conduct market audits, analysis, reporting, and remediation as part
of a workgroup
Assess provider pick job aids and provide recommendations for rules
engine development while acting as operational backup
Required Qualifications
3+ years of data analysis and/or audit experience in the healthcare
industry
3+ years of claims analysis and/or claims audit experience
Advanced understanding of UHG provider data, including knowledge of
NDB, OHBS Facets, or CSP Facets
Experience leading cross-functional workgroups and defining
detailed requirements for automation or user tools
Intermediate proficiency with Microsoft Excel
Keywords: VirtualVocations, South Whittier , Provider Data Consultant, Professions , Vista, California
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