Provider Network Reimbursement Analyst

About the Role

The Provider Network Reimbursement Analyst completes data analyses to support operational and strategic decision-making for the organization. This role is responsible for the collection, analysis, interpretation, and presentation of data from various sources, making data and analyses accessible, and delivering actionable data summaries. The analyst develops and recommends provider network reimbursement rates and processes that support the organization’s growth opportunities and competitive position in the market.

Responsibilities

• Conduct data analysis to support operational and strategic recommendations for the organization.
• Develop and maintain data visualization tools, including dashboards and reports, that enhance communication and engagement and support decision-making.
• Document data definitions, methodologies, and reporting processes.
• Monitor key performance indicators (KPIs) and provide actionable insights.
• Present data analysis findings at internal and external meetings and collaborate on resulting actions.
• Oversee data analysis and reporting timelines to ensure requests are completed on time and meet business requirements.
• Serve as a resource for researching claim and provider issues, identifying root causes, and presenting recommendations for resolution.
• Other job-related responsibilities may be assigned as required.

Requirements

• Bachelor’s degree or equivalent in Business, Economics, or Healthcare Informatics.
• Three (3) or more years in healthcare analytics, operations, or business intelligence/data analytics developing visualization tools (e.g., Power BI, Qlik Sense, Tableau).
• Demonstrated experience with data summarization and development and presentation of data analyses.
• Ability to evaluate data sources and identify the most efficient data extract and analysis tools.
• Proficient with relational databases and data query tools (e.g., SAS, SQL).
• Strong problem-solving, critical thinking, and analytical skills.
• Excellent written and verbal communication skills with the ability to influence and build relationships across various stakeholders.

Remote Work Requirements

• High-speed cable or fiber internet.
• Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at speedtest.net).

Pay

Salary Range: $73,000–$78,000. The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.

Work Location

Our first consideration is for this employee to live in the state of Wisconsin to take advantage of hybrid work and collaboration. Employees within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI, 53713) will be expected to work hybrid 2 days a week on a regular basis. As a secondary consideration, we offer remote work in the following approved states: Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Nebraska, New Jersey, North Carolina, Ohio, South Carolina, Texas, Virginia, and Wisconsin.

Benefits

• Remote and hybrid work options available.
• Performance bonus and/or merit increase opportunities.
• 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately).
• Competitive paid time off.
• Health insurance, dental insurance, and telehealth services starting DAY 1.
• Professional and Leadership Development Programs.

About Us

WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, Wisconsin. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS has been making healthcare easier for the people we serve for nearly 80 years. Proud to be military and veteran ready.

Culture

WPS’ culture is where the great work and innovations of our people are seen, fueled, and rewarded. We create an open and empowering employee experience, recognizing the benefits of employee engagement as an investment in our workforce. We seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.