Please note: This position is located in Strongsville but will transition to downtown Cleveland this year.
Working under direct to general supervision, develops custom provider network reports in response to requests from provider contracting and sales. Provides analytical support during the sales process for network provider geographic availability and disruption analyses and Request for Proposal (RFP). Ensures data integrity and up to date information in provider databases and technical documentation.
Receives network reporting requests from provider contracting and sales. Assesses and interprets customer needs and requirements. Develops, modifies, maintains and delivers routine to moderately complex custom reports from typically a singular data source.
Analyzes network provider geographic availability and disruption. Compares and summarizes the customer group's current network to the Company's and other networks sources. Reports on network adequacy and accessibility, plotting proximity of providers to homes of members in customer group.
Interprets data and analyzes results for Request for Proposal (RFP). Collaborates with sales proposal unit to understand requirements and deliver beneficial requested information.
Ensures data integrity of provider databases. Conducts data scrubs and organizes data to maximize opportunities for specialty analyses and improve quality of data.
Acquires and incorporates external data from other network sources the Company uses to maintain up to date databases.
Ensures technical documentation is up to date for various systems, services and business policies and processes, including databases and reporting procedures.
Maintains relationship with contracting and sales to understand ongoing reporting needs. Keeps up to date on Company products and services, internal movements, industry trends, regulations and related.
Performs other duties as assigned.
- Bachelor's degree in Business Administration, Statistics or related field or equivalent combination of training/education and experience.
- 1-5 years' progressive experience as a Provider Network Reporting Analyst or equivalent experience in health insurance provider operations/data management.
- Understanding of file structures, data definitions and relationships across all files.
- Knowledge of provider data structure, including tax ID, demographics, etc.
- Knowledge of systems applications and implementations.
- Intermediate to advanced Microsoft Office skills including spreadsheet and database reporting. Ability to create and analyze diverse sets of business data using Excel, Access, SQL, SSRS, QMF, Crystal Reports
- Ability to identify and investigate thematic trends in data.
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
- Top Workplace in Northeast Ohio. Year after year we've received this recognition!
- On-site wellness center at most locations. Enjoy personal trainers, towel service, locker room, weight room, elliptical machines, and a variety of classes!
- On-site cafeteria serving hot breakfast and lunch, at most locations. Choices ranging from salad bar, made to order, hot and cold sandwiches, or a variety of entrees cooked fresh daily. Convenience store at most locations
- Employee discount program. Discounts at many places in and around town, just for being a Medical Mutual team member
- Business casual attire
Excellent Benefits and Compensation:
- Competitive compensation plans
- Employee bonus program
- 401(k) with company match and an additional company contribution
- Excellent medical, dental, vision, and disability insurance
An Investment in You:
- Career development programs and classes
- Mentoring and coaching to help you advance
- Education reimbursement up to $5K per year
About Medical Mutual:
We strive to create peace of mind. Our customers can trust us to do things right and to help them get value from their health plan. We're the largest health insurer in Ohio and for over 80 years, we've been serving our members and the Ohio communities where they live and work. Medical Mutual is a Top Place to Work in Northeast Ohio with exceptional career opportunities that offer challenge, growth and a great work/life balance. We want talented, innovative, and driven people to help us continue to be the best health insurance choice of Ohioans and help make Ohio the best it can be! Our headquarter building is located in the heart of downtown Cleveland and we have multiple offices throughout the state. Join us at one near you!
At Medical Mutual we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Apply on company website