Overview
Skills
Job Details
Job Description
POSITION SUMMARY
Meet the needs of system users by meeting with the appropriate people to determine business needs; gather information in order to define and program reports, dashboards, and other solutions to meet those business needs; coordinate business critical projects from beginning to end; monitor, maintain, and complete all required regulatory reports and processes.
COMPLIANCE WITH REGULATIONS
Work closely with all departments necessary to ensure that the processes, programs, and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable state and federal regulations, including the Department of Health Care Services (DHCS) and the Centers for Medicare & Medicaid Services (CMS).
RESPONSIBILITIES
- Support company leadership by building reports, dashboards, and business intelligence solutions based on current business and compliance needs.
- Perform thorough data validation and reconciliation of reports to ensure accuracy.
- Analyze healthcare costs, member demographics, call center information, referral patterns, provider network accessibility, and other company data as needed.
- Provide analysis on enrollment, claims, authorization, and financial data as it pertains to Managed Care and construct necessary reports and datasets using SQL.
- Provide technical assistance by working independently or with Informatics Manager to assist users in the design and planning of projects; write, test, troubleshoot, and implement solutions using the standards established by the department; provide maintenance support; work with Informatics Manager to develop necessary databases; attend ongoing meetings related to projects; working on multiple projects concurrently.
- Provide information by writing documentation such as specifications, flowcharts, procedures, and training documentation; coordinate the development of solutions including reports and dashboards as required by the department, company, state and federal agencies; provide instruction and training for users and staff regarding new reports and solutions; participate in the evaluation of new software systems; provide solutions to users for technical and procedural problems; provide regular status reports to supervisor.
- Define and execute appropriate methods; maintain and develop the technical skills necessary to support the current computer system; adhere to standard testing methodology to ensure that new or modified programs have no adverse impact on systems operation.
- Enhance professional growth and development by participating in educational programs, reading current literature, attending in-service training and workshops, attending meetings as required, and participating on committees as directed.
- Support the team effort by arranging and conducting meetings; assist in the care and maintenance of department facilities, computer equipment, and supplies; maintain departmental policies and procedures, objectives, quality assurance program, safety, environmental and infection control standards; perform other related duties as requested or assigned.
- Maintain product and company reputation and contribute to the team effort by conveying professional image.
EDUCATION
- Bachelor s degree in Computer Science, Information Systems, Mathematics, or related technical discipline.
EXPERIENCE/SKILLS
- Five years of experience in database analysis, advanced SQL programming in SQL Server, Microsoft Access or equivalent relational database management tool.
- Experience in developing database and report specifications, test plans, and system documentation is preferred.
- Knowledge of SQL Server Reporting Services (SSRS), Microsoft Excel, and Visual Basic.
- Excellent oral and written communication; good analytical, logical and organization skills; excellent time management; ability to work on multiple projects concurrently; adherence to security requirements and confidentiality as required by the company and HIPAA.
- Experience with Tableau, Power BI, or other BI tool preferred.
- Experience in healthcare preferred.
- Experience with QNXT, Vistar, or eVIPs a plus.
PHYSICAL REQUIREMENTS
- Minimum 30 lb. Lifting.
- May be required to work evenings and/or weekends.
Community Health Group is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment based on any protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, and trainings. Community Health Group makes hiring decisions based solely on qualifications, merit, and business needs at the time. For more information, see Personnel Policy 3101 Equal Employment Opportunity/Affirmative Action
The above statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.