Provider-Reporting Analyst

LSMA Management Inc • San Bernardino, CA

4d

About The Position

The Provider-Reporting Analyst is responsible for reviewing, maintaining, and supporting provider configuration data to ensure accuracy, compliance, and operational efficiency. This role manages provider setup, fee schedule review, reporting development, and supports onboarding functions within the Managed Care (MCR) Eligibility & Benefits department. The Analyst will also develop complex reports and dashboards to support business operations, decision-making, and performance monitoring.

Requirements

• Bachelor's degree in Healthcare Administration, Business Administration, Public Health, Data Analytics, or related field.
• 3+ years of Managed Care Eligibility & Benefits or healthcare administrative experience.
• Working knowledge of provider data structures, contract terms, and reimbursement methodologies (e.g. Medicare, carve-outs, case rates, flat/base rates).
• Understanding of managed care operations, provider networks, credentialing, and basic claims concepts.
• Experience using EZ-CAP or similar managed care/claims systems.
• Basic understanding of fee schedule setup, mapping, and system maintenance.
• Familiarity with RAF scoring and its relevance to reporting or configuration.
• Ability to use reporting tools such as Crystal Reports, Tableau, Excel, and basic SQL.
• Strong analytical and critical-thinking skills; ability to follow detailed workflows.
• Ability to interpret contracts and translate requirements into system setup.
• Effective collaboration with internal teams (Provider Relations, IT, Finance, Claims, etc.).
• Strong documentation skills and commitment to accuracy.
• Ability to manage confidential information appropriately.
• Adaptability in a changing environment with evolving business and regulatory needs.
• Willingness to learn new systems, tools, and technologies.

Nice To Haves

• Master's degree in Healthcare Administration, Public Health, or related field.
• Experience in managed care, MSO, IPA, or health plan settings; familiarity with member eligibility, eligibility files, and systems such as EZ-CAP.

Responsibilities

• reviewing, maintaining, and supporting provider configuration data
• managing provider setup
• fee schedule review
• reporting development
• supporting onboarding functions
• developing complex reports and dashboards

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level