Lets do great things together!

About Moda
Founded in Oregon in 1955 Moda is proud to be a company of real people committed to quality. Today like then were focused on building a better future for healthcare. That starts by offering outstanding coverage to our members compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Lets be better together.

Position Summary
Provider Data Analyst I conduct analysis to support contract negotiations with medical providers. The analyst uses claims data as well as other data sources to model the impact of various contract terms. Functions include the use of analytic tools to pull data from Modas data warehouse analysis that converts the raw data into useful information and analytic summaries that communicate the information to the departments customers. This is a FT WFH position.

Pay Range
$59922.05 - $74902.56annually (depending on experience)
*This role may be classified as hourly (non-exempt) depending on the applicants location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Please fill out an application on our company page linked below to be considered for this position.

Dental Vision Pharmacy Life & Disability

• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Required Skills Experience & Education:

1. Bachelors degree required; Masters in healthcare administration or business administration is preferred.
2. Experience in the health insurance healthcare provider or public health industry is preferred.
3. Strong statistical analytical and problem-solving skills.
4. Experience with data analysis tools such as SAS SQL decision support systems business intelligence tools and/or Microsoft Access is preferred.
5. Experience with healthcare billing or claims data.
6. Intermediate Microsoft Excel skills and proficiency with all Microsoft Office products.
7. Ability to communicate effectively both verbally and in writing.
8. Ability to work well under pressure and with shifting priorities.
9. Ability to work collaboratively as part of a team.
10. Maintain confidentiality and project a professional business image.

Primary Functions :

1. Under direct supervision provide analytic support to determine bottom line impacts for proposed medical provider contract terms.
2. Evaluate the impact of new reimbursement methodologies on current Provider Billing practices.
3. Audit contract renewals to ensure reimbursement terms were interpreted and implemented correctly.
4. Update database that holds provider contract terms and analysis results.
5. Assess network functionality and potential for increased efficiency.
6. Build custom reports for contract negotiators to help achieve desired contract term agreements.
7. Perform ad hoc market research competitive analysis and other business analyses as needed.
8. Other duties as assigned.

Working Conditions:

• Office environment with extensive close PC and keyboard use constant sitting and frequent phone communication. Must be able to navigate multiple computer screens. A reliable high-speed hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek including evenings and occasional weekends to meet business need.
• Internally with multiple departments and committees.

Together we can be more. We can be better.