This position will support the 2Rs program (reinsurance and risk adjustment) as part of the implementation of the requirements of the Affordable Care Act overseen by the Actuarial Department.
The incumbent will be responsible for the planning, development, analysis, and implementation of procedures and/or processes to ensure accurate claims and enrollment data are submitted to the government;
Primary duties may include, but are not limited to:
Support and experience full project / software development lifecycle
- Analyze business requirements and assist in designing business solutions
- Perform unit acceptance testing of solutions developed by IT team
- Perform post-implementation verification after project deployment
- Write SQL queries to illustrate the issue or test the solutions
- Assist in the documentation of business processes
Develop and maintain management reporting dashboards
- Run reporting dashboards periodically based on program schedules
- Make necessary application enhancements to support dynamic changing business rules
- Develop and analyze functional data and performance reports
- Use SQL programming (DDLs, DMLs, aggregate/window aggregate/ordered analytical functions) in the creation and maintenance of the data mart
Perform data analysis, data profiling and research to support business initiatives or solve data issues
- Perform root cause analysis of errors and recommend solutions
- Manipulate large data sets and interpret results using data aggregation functions
- Validate data to ensure accuracy, quality and integrity
Perform ad hoc analytics and reporting
- Develop and analyze business performance (e.g. claims, membership data)
- Create and publish analytic reports, as well as any necessary ad hoc reports
Collaborate with internal and external partners in establishment, design and execution of business rules
Demonstrate ownership and accountability on assigned projects
Work with minimal supervision
Contribute to best practices.
*Bachelor Degree in Business Administration or Computer Science.
*4 years of information technology experience working on mainframe systems.
*4 years of experience with relational database technology.
*4 years of experience in a job requiring analysis with healthcare information data analysis.
*4 years of experience with SQL, Access, APL or other relational database systems tools.
*4 years of experience in system development and programming.
*Clear and concise verbal and written communication skills.
*Planning and organization skills.
*Teamwork and interpersonal skills.
*PC proficiency to include Word, Excel, PowerPoint and Outlook.
Preference will be given to candidates with the following skills, experience, knowledge, or education:
* Advanced SQL programming skills.
* Experience with Teradata or other database systems
* Experience in database design/development, database administration, and business intelligence
* Experience in data analysis and analytical reporting
* Proficiency with advanced Excel features and techniques; VBA skills desired
* Experience with dataset application programming (R, Python) desired
* Familiarity with agile/scrum or other project methodologies
* Strong analytical and problem solving skills
* Strong leadership and collaboration skills
* Ability to communicate ideas and results effectively
* Ability to manage conflicting priorities and multiple projects concurrently
* ACA claims/membership experience
Job ID: LMS-1022032