Data Analyst

AHS - 5.0

Little Rock, AR Job Details Full-time 22 hours ago Benefits Health savings account AD&D insurance Disability insurance Health insurance Dental insurance Flexible spending account Paid time off Vision insurance Life insurance Retirement plan Prescription drug insurance Qualifications Teamwork Data visualization software proficiency Medicare Business intelligence report generation

SQL ICD-10

Analysis skills Bachelor's degree Health insurance knowledge Organizational skills Microsoft Teams Medicaid Productivity software Health economics data analysis Data analytics technologies Database software proficiency Full Job Description This is an on-site/hybrid role in Little Rock, AR

ROLE AND RESPONSIBILITIES

The Data Analyst will support data-driven decision-making across a Third-Party Administrator (TPA) environment by analyzing complex datasets for multiple health plans, including Medicare, Medicaid, and self-funded commercial insurance. This role focuses heavily on Provider data (e.g., contracts, performance, network participation, credentialing, reimbursement, and utilization), while also supporting broader Payer and plan-level analytics to meet client, regulatory, and operational needs.

ESSENTIAL FUNCTIONS/RESPONSIBILITIES

Provider & Network Analytics:

Analyze provider data including demographics, specialties, contracts, credentialing status, network participation, and performance metrics across multiple plans Support provider network management initiatives such as network adequacy, access analysis, and provider performance benchmarking for Medicare, Medicaid, and self-funded clients Identify trends and anomalies in provider utilization, reimbursement, quality, and cost across plan types and employer groups Review provider, facility, group and organizational information for accuracy; identify discrepancies or conflicting relationships and research or escalate issues as appropriate Support ongoing network data integrity by recognizing duplicate, incomplete, or questionable information and ensuring appropriate resolution.

Claims & Plan Data Analysis:

Analyze medical and pharmacy claims data across Medicare, Medicaid, and self-funded commercial plans to identify cost drivers, utilization patterns, and opportunities for improvement Support client reporting and internal stakeholders with plan-level, employer-level, and provider-level analytics Develop reports and dashboards tailored to diverse client and regulatory requirements

Data Management & Reporting:

Extract, transform, validate, and reconcile data from multiple sources including claims systems, provider databases, eligibility files, and data warehouses Ensure data accuracy, integrity, and consistency across plans, clients, and reporting deliverables Create recurring and ad-hoc reports using SQL, BI tools, and spreadsheets Load, extract, maintain, and preserve provider and network data within a network management system in accordance with established workflow and data-integrity standards.

Insights, Compliance & Client Support:

Translate complex data into actionable insights for internal teams and external clients Support regulatory, audit, and accreditation reporting (e.g., CMS, state Medicaid agencies) as applicable Assist with responses to client data requests, performance guarantees, and operational inquiries

Collaboration & Continuous Improvement:

Assist with responses to client data requests, performance guarantees, and operational inquiries Partner with Provider Relations, Network Management, Client Services, Finance, Actuarial, Compliance, and IT teams Help define data requirements for new clients, plans, and employer groups Contribute to data governance, documentation, and continuous process improvement initiatives Perform task-oriented work through the Freshdesk ticketing system, including research, data review, loading, updates, documentation and follow-through to completion.

REQUIRED QUALIFICATIONS

Bachelor's degree in Data Analytics, Statistics, Mathematics, Health Informatics, Business, or a related field 2+ years of experience as a data analyst, preferably in a TPA, health plan, managed care, or healthcare services organization Strong SQL skills and experience working with large, complex relational datasets Experience analyzing healthcare data such as claims, provider, eligibility, or financial data Proficiency in Excel and at least one BI or visualization tool (e.g., Power BI, Tableau, Looker) Experience working in a TPA environment supporting multiple plan types (Medicare, Medicaid, self-funded commercial) Strong understanding of provider data including contracts, credentialing, network participation, and reimbursement models Familiarity with healthcare coding and standards (CPT, HCPCS, ICD-10, DRG, NPI) Ability to manage multiple priorities in a fast-paced environment. Proficiency with Microsoft Office Suite, TEAMS and Power BI Reporting.

COMPETENCIES

Strong analytical and critical-thinking skills High attention to detail and data accuracy across multiple clients and plans Ability to clearly communicate insights to technical and non-technical audiences Strong organizational skills and ability to manage competing priorities Understanding of TPA operations, client reporting, and provider relationships

ADDITIONAL NOTES

Fast-paced, multi-client environment with periodic deadlines working in office.

Job Type:

Full-time Benefits:

AD&D insurance Dental insurance Disability insurance Flexible spending account Health insurance Health savings account Life insurance Paid time off Prescription drug insurance Retirement plan Vision insurance

Education:

Bachelor's (Required)

Experience:

as a data analyst: prefer in a TPA, health plan: 2 years (Required)

Work Location:

Hybrid remote in Little Rock, AR 72201