JOB DETAILS

Provider Data Integrity Analys

CompanyTexas Children's Hospital
LocationBellaire
Work ModeOn Site
PostedAugust 2, 2026
About The Company
Texas Children’s Hospital is a world-class pediatric facility, nationally recognized as a top children’s hospital, and voted one of the best places to work in Houston for nine years running. We’re committed to creating a healthy community for children by providing the best pediatric care possible, through groundbreaking research and emphasis on education. We also offer a full continuum of family-centered care for women, from obstetrics to well-woman care. As a team member at Texas Children’s Hospital, you’ll work in an environment that values your voice. Texas Children's Hospital, headquartered in Houston, Texas, is recognized as one of America's best children's hospitals.
About the Role

We are searching for a Provider Data Integrity Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for the monthly audits and reconciliation of all Provider data within multiple systems within the Health Plan. To ensure that the Health Plan data is aligned with the States and that all Provider updates, including but not limited to adds, terms and changes are being made timely and accurately into our Core systems. Monitor the reporting of Provider data to support the Provider Relations teams, ensuring clean, accurate and timely data related to State regulations.

Think you’ve got what it takes

Job Duties & Responsibilities
•    Data management and analytics
•    Analyze reports and data sets for anomalies within the Provider data from multiple sources within the Health Plan
•    Identify and update data discrepancies between the State requirements and the Health Plan’s data
•    Coordinate and collaborate with Vendors, Providers, and other departments within the Organization to ensure that all systems are reconciled
•    Propose solutions to Business Partners for data integrity issues identified during your analysis
•    Always maintain data standards in alignment with the State and other Regulatory requirements
•    Manage data discrepancies and maintenance functions in an efficient, secure, timely manner with attention to all defined technical processes and use protocols
•    Technical accuracy of provider data integrity
•    Create and maintain policy and procedures for reconciliation and audit protocols of Provider data
•    Develop and document Business rules to support an external audit of our Provider data
•    Review updates from the State pertaining to Provider data to ensure that we remain Compliant.
•    Drive system, and or process changes to certify that all State requirements are met
•    Evaluate the Health Plan practices for performing this function and recommend any changes that are necessary to support data integrity
•    Evaluate datasets for consistency, completeness, accuracy and reasonableness
•    Support TCHP Provider Data Integrity initiatives
•    Generate data reports on periodic basis as requested or needed for the data management process
•    Identify and correct data deficiencies within the Health Plan Systems
•    Collaborate with our Provider Directory Vendor, ensuring accurate and timely data
•    Record and document as required data management activities, including but not limited to service forms, CRM’s, and the Master Provider File
•    Review and analyze the P files between the State and the Health Plan
•    Recommend and implement process improvement identified as needed by the Health Plan to support the continued integrity of the Provider data
•    Data integrity liaison between TCHP departments
•    Address any issues, questions and problems in accurate and timely manner
•    Self-solve issues if provider data integrity is in question
•    Educate other departments on data use and Business rule


Skills & Requirements
•    Required H.S. Diploma or GED and a preferred Bachelor's Degree
•    4 years Combined managed care contracting, provider reimbursement and analysis, strategic planning and/or project management experience
 


Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
Key Skills
Data managementData analyticsReconciliationAuditingManaged careProvider reimbursementStrategic planningProject managementRegulatory complianceData integrityReportingProcess improvementBusiness rulesCRMTechnical documentation
Categories
HealthcareData & AnalyticsAdministrativeFinance & Accounting
Job Information
📋Core Responsibilities
The Provider Data Integrity Analyst is responsible for the monthly audits and reconciliation of provider data across multiple systems to ensure alignment with state regulations. They will identify data discrepancies, collaborate with vendors and internal departments, and drive process improvements to maintain high standards of data accuracy.
📋Job Type
full time
📊Experience Level
2-5
💼Company Size
13245
📊Visa Sponsorship
No
💼Language
English
🏢Working Hours
40 hours
Apply Now →

You'll be redirected to
the company's application page