Data Analyst (flex-hybrid)

As a member of the Medicare Advantage Operations
team, Business Data Analyst is instrumental in independently developing the
detailed requirements specifications according to business needs.

In this role, you will:

• work directly
  with and serve as the liaison between business units, external trading
  partners, IT teams and support teams
• ensure functional and non-functional
  requirements are understood and implemented consistent with the Business Data Analyst's
  vision
• perform testing, design and delivery requirements
• work with the team
  to identify, analyze, quantify, and mitigate business risks
• collaborate with
  the training/development staff to deliver and update training documentation
• generate adhoc reports to support operations team as needed

• Bachelor's Degree in Business Administration, Information Systems, Health Care or other related field required
• Minimum of five (5) years' experience in a Medicare or Managed Care environment managing enrollment, claims or encounters required
• Minimum of five (5) years' experience with CMS processes in a Medicare or Managed Care environment required
• Experience with CMS processes is a plus
• Knowledge of SQL window based computer environment including MS Office and related programs is a plus
• Knowledge of encounter regulatory reporting and
  compliance requirements.
• Experience
  managing vendors to contractual requirements.
• Strong ability
  to research and resolve encounter issues.
• Strong
  knowledge of the health care model, capitation
  and other managed care IPA and provider reimbursement methodologies.
• Strong knowledge of physician and facility billing
  practices, appropriate CPT coding initiatives, ICD-10 coding standards, as well
  as Revenue and HCPCS coding.
• Strong
  leadership skills, with the ability to articulate goals,
  plan and implement processes to achieve those goals, recognize and assess the
  implications of confounding variables, anticipate consequences, and meet
  deadlines.
• Demonstrated ability to analyze and organize
  complex federal and private insurance regulations.
• Working knowledge of Microsoft Office
  Suite (Excel, Word, and PowerPoint) and data visualization tools.
• Skill in prioritizing and performing a variety of
  duties within a system that has frequently changing assignments, priorities and
  deadlines.
• Reliability and compliance with scheduling
  standards.
• Strong leadership and interpersonal skills
  
• Initiative, problem identification, resolution
  and analytical skills are essential.
• Excellent oral and written communication skills
  are required.
• Ability to modify and adapt operational
  procedures to changing operational needs
• Strong critical thinking and the ability to apply
  knowledge at a broad level within a complex academic medical center is
  essential.
• Ability to develop, implement, and
  evaluate methods and systems to improve efficiency.
• Proven skills to lead and facilitate
  cross-functional workgroups and other meetings.
• Ability to work as part of a team, collaborating
  with colleagues.
• Ability to analyze and organize complex federal and
  private insurance regulations.
• Must be effective at working
  independently with minimal supervision.
• Ability to support the working hours
  of the department.
• Ability to travel/attend off-site meetings and
  conferences.
• Ability to set and
  manage priorities judiciously
  
• Excellent interpersonal
  skills; demonstrated ability to give and receive constructive feedback
• Ability to articulate
  ideas to both technical and non-technical staff
• Exceptionally
  self-motivated; ability to motivate and participate in a team-oriented,
  collaborative environment.
• Superior analytical and
  problem solving abilities
• Must be customer service
  oriented, be able to work well individually and as part of a team; and have a
  strong work ethic.