Job Description
About The Company Founded in Oregon in 1955, Moda is a reputable healthcare organization dedicated to delivering exceptional coverage and compassionate support to its members and community. With a rich history rooted in quality and innovation, Moda continues to focus on building a better future for healthcare by connecting neighbors and creating healthier spaces and places. The company values diversity and inclusion, actively demonstrating its commitment through all business practices. Moda believes that diverse experiences and perspectives strengthen the organization, fostering a collaborative and inclusive environment where everyone can thrive. The company’s mission is to provide comprehensive benefits to employees, support community health initiatives, and maintain a steadfast dedication to quality care. About The Role The Provider Data Analyst I plays a vital role in supporting contract negotiations with medical providers by conducting detailed data analysis. This full-time, work-from-home position involves utilizing claims data and other relevant sources to model the financial and operational impacts of various contract terms. The analyst is responsible for extracting data from Moda’s data warehouse using analytic tools, transforming raw data into actionable insights, and preparing summaries that effectively communicate findings to stakeholders. The role requires collaboration with multiple departments to evaluate reimbursement methodologies, audit contract renewals, and assess network efficiency. The Provider Data Analyst I supports the organization’s strategic goals by providing accurate, timely, and insightful analysis to inform decision-making processes related to provider contracts. Qualifications Bachelor’s degree in healthcare administration, business administration, or related field (Master’s preferred) Experience in health insurance, healthcare provider, or public health industry (preferred) Strong statistical, analytical, and problem-solving skills Proficiency with data analysis tools such as SAS, SQL, decision support systems, business intelligence tools, or Microsoft Access (preferred) Experience working with healthcare billing or claims data Intermediate proficiency in Microsoft Excel and comprehensive knowledge of Microsoft Office suite Effective verbal and written communication skills Ability to work efficiently under pressure and adapt to shifting priorities Strong teamwork and collaboration skills Ability to maintain confidentiality and demonstrate professionalism in all interactions Responsibilities Provide analytic support to evaluate the financial impact of proposed medical provider contract terms under supervision Analyze the effects of new reimbursement methodologies on current provider billing practices Audit contract renewals to ensure accurate interpretation and implementation of reimbursement terms Maintain and update the database containing provider contract terms and analysis results Assess network functionality and identify opportunities for increased efficiency Create custom reports to assist contract negotiators in achieving desired contract terms Conduct ad hoc market research, competitive analysis, and other business-related analyses as needed Collaborate with cross-functional teams and departments to support organizational goals Perform other duties as assigned to support the healthcare organization’s objectives Benefits Medical, Dental, Vision, Pharmacy, Life, and Disability insurance coverage 401(k) retirement plan with company matching Flexible Spending Accounts (FSA) Employee Assistance Program (EAP) Paid Time Off (PTO) and company-paid holidays Opportunities for professional development and career growth Remote work flexibility and supportive work environment Equal Opportunity Moda Health is committed to providing equal employment opportunities to all qualified applicants and employees without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status, or any other protected status under applicable law. This commitment extends to all employment practices, including recruiting, hiring, promotion, termination, compensation, and training. We strive to foster an inclusive environment where diversity is valued and everyone has the opportunity to succeed. For questions related to accommodations or further information, please contact Kristy Nehler and Danielle Baker via our human resources email.