Research Analyst - Medical Management, Remote

Research Analyst - Medical Management, Remote life insurance, parental leave, 401(k), remote work Description Research Analyst - Remote Under the direction of the Head of Providence Health Plan (PHP) Payment Integrity (PI), the Research and Development (R&D) Analyst is responsible for identifying, developing, and implementing solutions to improve the accuracy and integrity of claims payments across the Plan. This role focuses on preventing and reducing unnecessary spending by scoping PI initiatives, analyzing claims data, developing a thorough implementation assessment plan, and collaborating with internal and external stakeholders to optimize the payment processes. This is accomplished by leveraging a deep understanding of Providence Health Plan infrastructure, claims edit and processing platforms, Plan policy, regulatory/compliance, benefit, and contracting functions to synthesize meaningful and actionable PI initiative recommendations. Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. This role offers 100% remote work for candidates residing in: Washington California Required Qualifications: Bachelor's Degree, or 3 years equivalent experience. 3 years experience with performance improvement/organizational change tools. 3 years experience working with large data sets and analytics teams. 3 years claims processing experience within the health insurance industry. Experience with reimbursement methodologies, including the Centers for Medicare & Medicaid Services (CMS), provider contracts, and medical coding practices. Healthcare experience in project coordination encompassing operations analysis, outcomes measurement methodology, data management and quality improvement process design. Salary Range by Location: California: Humboldt: Min: $33.05, Max: $51.30 California: All Northern California - Except Humboldt: Min: $37.08, Max: $57.56 California: All Southern California - Except Bakersfield: Min: $33.05, Max: $51.30 California: Bakersfield: Min: $31.71, Max: $49.22 Oregon: Non-Portland Service Area: Min: $29.56, Max: $45.88 Oregon: Portland Service Area: Min: $31.71, Max: $49.22 Washington: Western : Min: $33.05, Max: $51.30 Washington: Southwest - Olympia, Centralia & Below: Min: $31.71, Max: $49.22 Washington: Eastern: Min: $28.21, Max: $43.80 Washington: South Eastern: Min: $29.56, Max: $45.88 Why Join Providence Health Plan? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. Posted are the minimum and the maximum wage rates on the wage range for this position. The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on‑call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well‑being resources and much more. Learn more at providence.jobs/benefits. Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. About the Team Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 438169 Company: Providence Jobs Job Category: Research Job Function: Clinical Support Job Schedule: Full time Job Shift: Day Career Track: Clinical Professional Department: 5018 HCS MEDICAL MANAGEMENT OR REGION Address: OR Portland 4400 NE Halsey St Work Location: Providence Health Plaza (HR) Bldg 1-Portland Workplace Type: Remote Pay Range: $See Posting - $See Posting The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on‑call, overtime, premiums, extra shift incentives, or bonus opportunities. Helping all candidates find great careers is our goal. The information you provide here is secure and confidential. We are now directing you to the original job posting. Please apply directly for this job at the employer’s website. #J-18808-Ljbffr Providence Health & Services