Provider Data Analyst - 26-54

PriMed Management Consulting Services, Inc. is seeking a Provider Data Analyst to support provider data operations for Hill Physicians. In this role, you’ll help keep provider information accurate across health plan systems, directories, and downstream reporting by working in the Salesforce system of record. You’ll also create reports and dashboards to monitor data quality and operational performance, leveraging approved AI-enabled capabilities to streamline intake, validation, reconciliation, and exception handling.

Location: Sacramento, CA (onsite)
Salary: $70,000 - $88,000 per year
Education: Bachelor’s degree (or equivalent experience)

What you’ll do

• Enter, update, and maintain complete and accurate provider demographic, billing, and 30 contract data (adds, changes, and terminations) across systems.
• Update provider data in accordance with compliance requirements, processing rules, and guidelines while meeting department SLAs and required timelines.
• Track, document, and resolve provider data requests and inquiries by investigating issues, validating corrections, and providing status updates and routine data extracts or reports as needed.
• Create, maintain, and distribute provider rosters, including outreach lists, to validate required information and ensure accuracy, completeness, and timeliness.
• Support internal and external audits and compliance activities, including CA SB 137 quarterly audits, by gathering documentation, completing assigned analysis, and responding within established timelines.
• Create and route provider change request forms and manage provider portal accounts as assigned.
• Assist with system enhancements by documenting requirements, executing test cases, and validating results to strengthen data accuracy and controls.
• Support data cleanup and remediation initiatives, including coordination, action tracking, and status updates.
• Conduct root-cause, gap, and trend analyses for provider data issues, document findings, and share recommendations with the team.
• Maintain working knowledge of provider data sources and end-to-end data flows, including downstream reporting impacts.
• Identify automation opportunities, help define business requirements, and validate implemented workflows.
• Use approved AI and automation tools to streamline data management tasks such as intake triage, validation, deduplication, reconciliation, and exception handling, and track basic efficiency metrics.
• Create ad hoc provider roster reports and quality assurance dashboards to support data validation, monitoring, and operational decision-making.
• Support health plans and external partners with provider data, including directory accuracy, routine issue resolution, and audit support, escalating as needed.
• Troubleshoot provider data and system-related inquiries by following steps, communicating status, and escalating to the appropriate teams and vendors.
• Log, track, and escalate issues as needed and communicate progress through closure to meet time-sensitive needs.
• Compile, summarize, and format data and findings for review by leadership and stakeholders.
• Create and maintain team documentation and training materials to support consistent processes and knowledge sharing.
• Assist with provider data projects and perform other related duties as assigned.

What you bring

• Bachelor’s degree required or equivalent experience.
• Experience supporting or coordinating projects (task tracking, documenting decisions, communicating status).
• Proficient data analysis skills, including data validation, trend analysis, and root-cause investigation.
• Proactive, solutions-oriented approach with comfort adapting to new systems, processes, and regulations.
• Ability to prioritize and manage multiple deadlines, with strong follow-through and comfort working independently and in a team environment.
• Ability to recognize when to ask questions and escalate issues appropriately for time-sensitive needs.
• Excellent written and verbal communication skills to partner effectively with cross-functional teams.
• Ability to work accurately under deadlines while balancing competing priorities.
• Proficiency in Microsoft Office Suite.

Preferred / helpful experience

• Intermediate Microsoft Excel skills (formulas, filters, pivot tables, and basic reconciliations) with ability to work with large datasets.
• Experience with reporting and visualization tools (e.g., Tableau) preferred.
• Experience using approved AI tools to support data quality and operational workflows.

Tools you’ll use

• Salesforce
• Microsoft Office Suite
• Microsoft Excel
• Tableau

General working style

• Open-minded and adaptable in a changing environment.
• Team-focused critical thinker who collaborates with curiosity and critical thinking.
• Enjoys root-cause analysis and continuous improvement.
• Strong time management, organizational skills, and attention to detail.
• Clear communication with partners at all levels, including leadership.