DIRECTORY ANALYST

COMPANY INFORMATION

 

Group Health Incorporated (GHI) is a statewide, not-for-profit insurer serving New Yorkers since 1937. GHI and its wholly-owned subsidiary, GHI HMO, provide health coverage and administrative services to more than 2.6 million individuals, offering a variety of insurance options and administrative-services-only arrangements.

 

JOB DESCRIPTION

 

Manage provider data flows and assure timely publication of the GHI Provider Directory.  Assure the collection and maintenance of accurate and complete provider data for the production of the Provider Directory. Publish correct and comprehensive Provider Directories on a bi-annual or requested basis.  Develop workflows for efficient and timely completion of assigned tasks. Identify data collection obstacles and develop an action plan to ensure compliance.  Analyze and update workflow between the Provider Relations, Credentialing and Provider Correspondence departments.  Act as a liaison between Provider Operations, Network Management, MIS, Service, Membership, Ancillary, Hospital Contracting, and external vendors to define business needs and solutions.  Lead interface with credentialing verification organizations (CVO) and credentialing system vendors.  Conduct studies, analyze account requirements and perform cost/benefit analysis when required.  Identify alternate system approaches, develop recommendations, prepare reports and make presentations to designated departments.  Assist with the development of project plans and schedule, monitor and communicate projects as required.  Analyze and update workflow between the Provider Relations, Credentialing and Provider Correspondence departments to support efficiency and timely completion of enrollment and file maintenance requests.  Utilize MIS solutions to reduce the department workload as is appropriate.  Analyze data, conduct network audits, and assist Supervisors with staff training on department processes.  Develop written report of various audit processes, develop audit tools, and create action plan to ensure compliance.  Perform other duties and handle special projects as assigned by the Manager/Director

 

 

 

QUALIFICATIONS:

 

Bachelor?s degree.

3-5 years of experience in Insurance Operations.

2 or more years of experience working with data analysis and/or producing directory

2 or more years of experience working in IT environment preferred.

Excellent analytical, communication, interpersonal, and project-management skills.

Ability to interact effectively with all levels of management.

Working knowledge of spreadsheet, word processing and graphic software.

 

HOW TO APPLY

 

We offer a competitive salary and comprehensive benefits package. For immediate consideration, please

send your resume with salary requirements to: G. Valentin, Sr. Employment Specialist, Group Health Inc.,

441 Ninth Avenue, New York, New York 10001. Fax: 212-563-8563. Email:  gvalentin@ghi.com EOE