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Cassandra Jones

Senior Provider Data Analyst

Driving data integrity, enrollment accuracy, and operational efficiency across large national health plans — with 6+ years translating complex contracts into audit-ready pricing.

View Experience Contact Me
Experience
6+ yrs
Providers
10K+
Backlog ↓
30–40%
Cassandra Jones — Senior Provider Data Analyst

Cassandra Jones

Phoenix, Arizona

Healthcare Reimbursement • Top Skill
SQL · Power BI · Excel · Portico · Amisys
Protecting margin · Ensuring compliance
Led teams of 30+ analysts
Certified Six Sigma Principles · KSU

About

Pricing, precision, and protecting margin.

Senior healthcare pricing and provider network analyst with 6+ years of experience optimizing reimbursement, validating contract rates, and improving network cost performance across large national health plans.

I specialize in translating complex contract terms into accurate, audit-ready pricing that protects margin while supporting strong provider relationships. My work spans hospitals, clinics, and practitioner networks — validating contract-based rates, auditing pricing accuracy, and partnering with contracting, finance, and claims teams.

Core focus: financial impact analysis, pricing validation, and data integrity — helping organizations avoid revenue leakage and maintain compliance.

Core Expertise

Where I deliver measurable value.

Provider Network Pricing

Multi-state hospital and clinic contract pricing changes, implementation, and validation aligned to contract terms.

Reimbursement Modeling

Validating contract-based schedules, pre-analysis of pricing requests, and downstream financial impact assessments.

Audit & Compliance

Targeted audits, discrepancy resolution, audit-ready documentation, and control-gap identification.

Data Integrity

Provider data validation, root cause analysis, and cross-system reconciliation to support clean claims.

Reporting & BI

SQL, Power BI, Tableau, and Excel reporting for inventory, SLA adherence, and operational visibility.

Team Leadership

Led 30+ analysts (onshore & offshore), mentored peers, and drove SLA, quality, and productivity performance.

Tools & Platforms

SQL Power BI Tableau Advanced Excel Portico Amisys Salesforce AS400 ServiceNow

Experience

A track record across national payers.

  1. Open to Work

    Feb 2026 — Present

    Mesa, AZ · Remote · Hybrid · In Office

    • Led teams of 30+ analysts including offshore partners — SLA & quality adherence.
    • Oversaw provider data operations supporting 10,000+ providers, reducing backlog 30–40%.
    • Drove root cause analysis and cross-functional issue resolution in high-volume environments.

  2. Network Pricing Analyst — US Tech Solutions (CVS Health)

    Jun 2025 — Feb 2026

    Remote

    • Implemented pricing changes across multi-state hospital and clinic contracts.
    • Validated reimbursement schedules to prevent revenue leakage.
    • Partnered with underwriting, benefits, finance, and account services teams.

  3. Sr Network Pricing Analyst — Rose International (CVS Health)

    Jun 2024 — Feb 2025

    Scottsdale, AZ

    • Conducted targeted audits to identify errors, variances, and control gaps.
    • Maintained audit-ready pricing logs to support internal reviews.
    • Aggregated pricing and quality data across multiple systems.

  4. Supervisor, Provider Enrollment & Data Management — Centene

    Nov 2021 — Dec 2023

    Remote

    • Managed data integrity across hospital, clinic, and practitioner networks.
    • Led corrective initiatives that reduced backlogs and overturned audit findings.
    • Mentored analysts, contributing to skill development and internal promotions.

  5. Provider Data Management Analyst — Centene

    Oct 2019 — Nov 2021

    Tempe, AZ

    • Executed provider data management per plan, contract, and business rules.
    • Resolved provider data discrepancies and system issues.

Signature Project

Overturning QA audit errors at Centene.

Identified a significant spike in provider enrollment errors and QA backlog. Assembled a cross-functional task force, uncovered a process gap between enrollment training and QA audit criteria, and led the corrective alignment.

30–40%

Backlog reduction across provider data operations.

10K+

Providers supported across hospital & clinic networks.

100%

Audit findings overturned after process alignment.

Education

Continually learning.

2011 — 2012

MBA, Business Operations

American InterContinental University

Aug 2023 — Oct 2023

Business Analytics Certification

Kennesaw State University — SQL, Tableau, Data Modeling

Certifications

Verified credentials.

Six Sigma Principles

Kennesaw State University

Issued Apr 2026 · Credential ID OT2KI4TG2NKH

Top Skill Endorsement

Healthcare Reimbursement

Let's Connect

Ready for your next pricing analyst.

Looking for a data-driven, detail-oriented Senior Analyst who delivers accuracy, efficiency, and business value? Let's talk.

Phoenix, Arizona 189 LinkedIn connections Open to Remote, Hybrid & On-site