Provider Data Services Consultant

Company: Aetna
Location: Baton Rouge
Posted on: January 17, 2020

Job Description:

Req ID: 67261BRJob DescriptionProvides support for provider data transactions associated with projects, expansions, and new product implementations. Resolves high volume/high impact systemic problems through proactive and reactive mechanisms (e.g. automation, route audit programs, data reporting, root cause analysis).Fundamental Components included but are not limited to:

• Identifies, researches and conducts root cause analyses (e.g. problem providers identified by PST, rework and audit trends) and recommends process improvements.
• Establishes, maintains and aligns complex contracted provider demographic data and negotiated reimbursement arrangements across provider systems.
• Creates and manages action plans for assigned projects relative to data quality and/or workflow improvements.
• Ensures that all impacted constituents are considered and appropriately addressed in action plans.
• Provides technical and/or functional leadership within unit (i.e., team lead).
• Performs validation of system enhancements.
• Extract information from provider systems to meet business reporting needs (i.e., DAF reports, fee schedule reports, Service Center Log.Qualifications Requirements and Preferences:
  • 3+ Years of experience and knowledge of Provider Data Services systems and other end user applications.
  • 1-2 years of project management experience preferred
  • Bachelor's degree or equivalentBenefit EligibilityBenefit eligibility may vary by position.Job Function: HealthcareAetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.

Keywords: Aetna, Baton Rouge , Provider Data Services Consultant, Professions , Baton Rouge, Louisiana