Data Specialist

Description:

Verda Health Plan of Texas has a contract with the Center of Medicaid and Medicare Services (CMS) and a state license with the Texas Department of Insurance for a Medicare Advantage Prescription Drug (MAPD) plan. We are committed to the idea that healthcare should be easily and equitably accessed by all. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a Data Specialist to join our growing company with many internal opportunities.

Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare health plan is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.

Align your career goals with Verda Healthcare, Inc. and we will support you all the way.

Position Overview
The Data Specialist is responsible for ensuring the accuracy, integrity, and accessibility of data that drives compliance, quality reporting, member engagement, and operational efficiency. This person will collaborate closely with departments including Compliance, Claims, Quality, Enrollment, Clinical Operations, Finance, and IT to ensure data consistency and availability for both internal analysis and external reporting. The Data Specialist will be working with large datasets, be proficient in SQL and business intelligence tools, and operating in a fast-paced, highly regulated environment. The person will leverage their expertise working with healthcare data and strong understanding of CMS regulations and Medicare Advantage plan operations to process and analyze data efficiently.

This position reports to the Business Systems Manager.

Responsibilities:

· Collect, clean, validate, and maintain data sets related to Medicare Advantage membership, claims, provider assignment and revenue.

· Collaborate with compliance, quality, actuarial, and clinical teams to ensure data alignment and reporting accuracy.

· Conduct data analyses to support performance monitoring, business intelligence, and quality improvement initiatives.

· Build and maintain dashboards and reports using tools such as Excel, SQL, Tableau, or Power BI.

· Identify and resolve data integrity and quality issues through audits and collaboration with IT or vendor partners.

Requirements:

Minimum Qualifications

· Bachelor’s Degree in business, computer science, information technology, or equivalent business experience.

· Prior experience at a health plan or MSO.

· Strong experience working with healthcare data.

· Strong understanding of CMS regulations and Medicare Advantage plan operations.

· Knowledge of MS Office Suite, including Excel and Word.

Professional Competencies

· Collaborative approach with vendors and internal team members.

· Strong analytical skills.

· Effective verbal and written communication.

Verda cares deeply about the future, growth, and well-being of its employees. Join our team today!

Job Type: Full-time

Benefits:

• 401(k)
• Paid time off (vacation, holiday, sick leave)
• Health insurance
• Dental Insurance
• Vision insurance
• Life insurance

Schedule:

• Full-time onsite (100% in-office)
• Hours of operations: 9am – 6pm
• Standard business hours Monday to Friday/weekends as needed
• Occasional travel may be required for meetings and training sessions.

Ability to commute/relocate:

• Reliably commute or planning to relocate before starting work (Required)

PHYSICAL DEMANDS

Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.

*Other duties may be assigned in support of departmental goals.