Temp - Provider Data Analyst at San Francisco Health Plan – San Francisco

Reporting to Manager, Provider Network Operations, the Provider Data Analyst supports the Provider Network Operations team by delivering applicable insights through data analysis and reporting.

You will play an important part in evaluating network adequacy, assessing access to care, ensuring provider data integrity, and usability of provider-related data within SFHP. You will analyze complex datasets to support provider network management, compliance, and operational decision-making. The analyst will collaborate with cross-functional teams to identify data discrepancies, develop reporting solutions, and optimize data workflows that enhance provider data quality.

By leveraging data insights, you will contribute to improving provider credentialing processes, network adequacy, and overall member care coordination. You will have strong interpersonal and communication skills, natural leadership abilities, and professional data configuration and analytic experience from a managed care organization. Also, the Provider Data Analyst serves as the functional lead for provider-related application configuration (QNXT). This includes project planning, configuration execution oversight, test planning/UAT leadership, and change/release management accountability for provider-related configuration changes.

Please note that while SFHP supports a hybrid work environment, the Temp-Provider Date Analyst is not required to meet the minimum in-office requirement of 4x/month but is required to attend meetings and other in-person events at Manager's discretion.

Salary: $37.92 - $44.06 per hour

WHAT YOU WILL DO:

• Analyze provider network data to support strategic initiatives related to network adequacy, access to care, credentialing, contracting, and regulatory compliance.
• Develop and maintain dashboards and reports using Power BI and Tableau to visualize provider data trends and operational performance.
• Perform ad hoc analyses to identify data discrepancies, gaps in access, and opportunities for network optimization.
• Collaborate with teams to ensure provider data accuracy and understanding of organizational goals.
• Monitor and report on main metrics related to provider participation, network coverage, and compliance with regulatory standards.
• Use SQL and other data tools to extract, transform, and analyze complex datasets from systems such as QNXT and other managed care platforms.
• Support internal audits and data validation efforts to ensure integrity and reliability of provider data.
• Compile and interpret large sets of data and provide reports and/or presentations on impact and implications of the findings.
• Maintain confidentiality and comply with regulatory requirements.
• Create and produce new documents, and presentations of analysis results; respond to ad hoc requests.
• Perform implementation and configuration activities including prototyping, analysis, system configuration, operational implementation, and process documentation (provider-related scope).
• Demonstrate subject matter expertise in at least one main QNXT module (provider-related configuration).
• Recommend and implement configuration changes to improve the efficiency of provider-related system processing and downstream outputs (directory/rosters, reporting).
• Lead testing strategy: work with UAT/end-users to develop and execute test plans to verify configuration changes work as intended; ensure defects are logged and resolved.
• Manage adherence to SFHP Change Management/Release Management policies for provider-related changes (change tickets, approvals, release notes, evidence, rollback considerations).
• Document functional specifications for provider-related system solutions/enhancements and maintain a configuration decision log/knowledge base.

WHAT YOU WILL BRING:

• Bachelor's degree in Health Informatics, Data Science, Business Administration, Healthcare Administration, or a related field; or equivalent work experience
• We require two years of experience with detailed analytics including root cause analysis, statistical analysis, and interpretations of data.
• Proficiency in data analysis tools such as SQL, Excel, or similar database querying and manipulation software
• We prefer experience using data reporting programs and databases.
• We prefer two years of experience using, configuring or reporting from managed care Core Administration Systems such as QNXT, Facets or related.
• Familiarity with Medi-Cal, Medicare, and other government-sponsored health programs
• Familiarity with Lean project management principles and experience applying project management methodologies to operational initiatives
• Proficiency in SQL for data extraction and analysis
• Expertise in data visualization tools such as Power BI and Tableau
• Familiarity with managed care system including QNXT or similar platforms
• Interpret complex datasets and translate findings into applicable insights
• Experience supporting or leading system configuration and UAT/testing in a regulated environment (preferred)
• Experience with ticketing/change tools (ServiceNow/Jira) and controlled documentation (preferred)
• Working knowledge of claims processing concepts as they relate to configuration impacts (preferred)

WHAT WE OFFER:

• Health Benefits
  • Medical: You'll have a choice of medical plans, including options from Kaiser and Blue Shield of California, heavily subsidized by SFHP.
  • Dental: You'll have a choice of a basic dental plan or an enhanced dental plan which includes orthodontic coverage.
  • Vision: Employee vision care coverage is available through Vision Service Plan (VSP).
• Retirement – Employer-matched CalPERS Pension and 401(a) plans, 457 Plan.
• Time off – 23 days of Paid Time Off (PTO) and 13 paid holidays.
• Professional development: Opportunities for tuition reimbursement, professional license/membership.

ABOUT SFHP:

Established in 1997, San Francisco Health Plan (SFHP) is an award-winning, managed care health plan whose mission is to provide affordable health care coverage to the underserved low and moderate-income residents in San Francisco County. SFHP is chosen by eight out of every ten San Francisco Medi-Cal managed care enrollees and its 175,000+ members have access to a full spectrum of medical services including preventive care, specialty care, hospitalization, prescription drugs, and family planning services.

San Francisco Health Plan is proud to be an equal opportunity employer. We are committed to a work environment that supports, inspires, and respects all individuals and in which our people processes are applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristics.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

San Francisco Health Plan is an E-Verify participating employer.

Hiring priority will be given to candidates residing in the San Francisco Bay Area and California.

#LI-Hybrid

(Hybrid remote/in-office)