PURPOSE OF THIS JOBThe Business Intelligence Developer - Medicaid role is responsible for the design, creation, and maintenance of sustainable reporting solutions and analytical insights that improve efficiency, drive innovation, and inform data driven decision making in support of broader business and corporate strategies across the organization.
This position partners with business leaders across the organization to provide high quality reporting and analysis that is accurate, thoroughly researched, assists in identifying risks & opportunities, and provides untapped insights and knowledge to enable data driven and data literate decision making for departments and teams throughout the entire Medicaid segment.
REQUIRED QUALIFICATIONSRequired Work Experience- Applies to All Levels
- 2 years of experience working with data, report development, and analysis in a workplace setting
- 1 year of experience in query design and effective reporting design structure
- Applies to Levels 2-3
- 4 years of experience working with data, report development, and analysis in a workplace setting
- 3 years of experience in query design and effective reporting design structure
- Applies to Levels 4-6
- 8 years of experience working with data, report development, and analysis in a workplace setting
- 6 years of experience in query design and effective reporting design structure
Required Education- Applies to All Levels
- High-School Diploma or GED in general field of study
- Applies to Levels 4-6
- Bachelor's degree (B.S.), or equivalent education and/or experience, in Computer Information Systems, Computer Science, Information Technology, Business Administration, Healthcare Administration, or other pertinent degree obtained at a four-year college or university.
Required LicensesRequired CertificationsPREFERRED QUALIFICATIONSPreferred Work Experience- Applies to All Levels
- 1 year of experience in a healthcare, health insurance, or managed care environment
- 1 year of experience working with Medicaid and/or Medicare D-SNP programs
- 1 year of experience managing projects
- Applies to Levels 2-3
- 2 years of experience in a healthcare health insurance, or managed care environment
- 2 years of experience working with Medicaid and/or Medicare D-SNP programs
- 3 years of experience managing projects
- Applies to Levels 4-5
- 4 years of experience in a healthcare health insurance, or managed care environment
- 4 years of experience working with Medicaid or Medicare D-SNP programs
- 6 years of experience managing multiple projects
- Applies to Level 6
- 6 years of experience in a healthcare health insurance, or managed care environment
- 6 years of experience working with Medicaid or Medicare D-SNP programs
- 8 years of experience managing multiple projects
- 2 years of supervisory or management experience
Preferred Education- Applies to All Levels
- Bachelor's degree (B.S.), or equivalent, in Computer Information Systems, Computer Science, Information Technology, Business Administration, or Healthcare Administration obtained at a four-year college or university.
- Applies to Levels 5-6
- Master's degree, or equivalent, in Computer Information Systems, Computer Science, Information Technology, Business Administration, or Healthcare Administration obtained at a four-year college or university.
Preferred LicensesPreferred Certifications- MS SQL Certification or other certification in current programming languages (Applies to All Levels)
ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIESALL LEVELS- Each progressive level includes the ability to perform the essential functions of any lower levels and mentor employees in those levels.
- Meet timeliness and accuracy goals.
- Use sound project management methodology and demonstrate solid time management skills.
- Effectively communicate status of work assignments to stakeholders and management via department defined communication channels and policy.
- Design, develop, or maintain reporting and/or analysis of data to measure financial or clinical outcomes, network performance, care management, claims processing, operations and/or other areas of the business
- Design, develop, or maintain reporting and/or analysis of data for medical cost reporting, categories of service, unit cost and financial utilization metrics
- Design, develop, or maintain reporting and/or analysis of data for clinical utilization, authorization, care management, risk adjustment, and claims data to support departmental functions
- Receives, interprets, and completes data requests from Finance and other departments as necessary
- Responsible for technical and production support documentation in accordance with department standards and industry best practices.
- Adhere to established source control versioning policies and procedures
- Participate in all aspects of the Systems Development Life Cycle (SDLC)
- Participate in corporate quality and data governance programs
- Implement and maintain operational and disaster-recovery procedures.
- Maintain current knowledge on new developments in technology-related industries
- This position has an onsite expectation of 1 day per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
- Perform all other duties as assigned
Level 1 - Performs job functions with general supervision- Learn area's workflow, procedures, and processes.
- Become familiar with and demonstrate a basic understanding of:
- The various areas and types of Business Intelligence reporting and analysis.
- The various reporting platforms utilized by Business Intelligence (Excel, SSRS, Tableau, Qlik Sense, etc.)
- How the Business Intelligence reporting and analysis' impact the operations and performance of the business.
- What the key departments are, their primary functions, and roles.
- The numerous systems and data sources utilized by Business Intelligence, their purpose, structure, limitations, and functional roles in Business Intelligence reporting and analysis.
- Participates in small projects of basic complexity.
- Designs, develops, and enhances basic-level Business Intelligence reporting.
- Designs and codes basic-level queries and data sets, using the appropriate structured programming techniques, formatting, reporting platform, and associated programming languages.
- With mentor, learns to develop work-plans, write & execute unit test plans, and track & resolve any processing issues.
- Shadows mentor in requirement gathering with business partners and SME's; ensuring that requirement scoping is complete, consistent, concise, comprehensible, traceable, feasible, unambiguous, verifiably actionable, and agreed upon by all parties.
- Shadows mentor in the design, development, and maintenance of dashboard visualizations using BI applications. (Tableau, Qlik Sense, Power BI, etc.)
- Shadows mentor in ensuring dashboards and other Business Intelligence reporting and analysis are creatively designed and tell a story behind the data.
- Shadows mentor in the review of code and/or reporting/analysis for proper design standards, content, accuracy, functionality, and overall compliance with the desired purpose of the requester.
- With mentor, learns the process and participates in the development and creation of documentation used to support associated reporting and analysis.
- Monitors, maintains, refreshes, and distributes regularly scheduled standard reporting and data extracts
- Reports to lead, supervisor, or manager who provides general supervisory instructions, manages workload and reviews overall results.
Level 2 - Performs job functions with general supervision- Participates in and follows all area workflow, procedures, and processes.
- Demonstrates a general understanding and beginning mastery of:
- The various areas and types of Business Intelligence reporting and analysis.
- The various reporting platforms utilized by Business Intelligence (Excel, SSRS, Tableau, Qlik Sense, etc.)
- How the Business Intelligence reporting and analysis' impact the operations and performance of the business.
- What the key departments are, their primary functions, and roles.
- The numerous systems and data sources utilized by Business Intelligence, their purpose, structure, limitations, and functional roles in Business Intelligence reporting and analysis.
- Participates in small to medium sized projects of basic or moderate complexity.
- Designs, develops, and enhances basic to moderately complex Business Intelligence reporting.
- Designs and codes basic to moderately complex queries and data sets, using the appropriate structured programming techniques, formatting, reporting platform, and associated programming languages.
- With mentor, demonstrates basic ability to develop work-plans, write & execute unit test plans, and track & resolve any processing issues.
- With mentor, learns the process of requirement gathering with business partners and SME's; ensuring that requirement scoping is complete, consistent, concise, comprehensible, traceable, feasible, unambiguous, verifiably actionable, and agreed upon by all parties.
- With mentor, learns effective design, development, and maintenance of dashboard visualizations using BI applications. (Tableau, Qlik Sense, Power BI, etc.)
- With mentor, learns to develop dashboards and other Business Intelligence reporting and analysis are creatively designed and tell a story behind the data.
- With mentor, learns the methodology and process to review code and/or reporting/analysis for proper design standards, content, accuracy, functionality, and overall compliance with the desired purpose of the requester.
- With mentor, demonstrates basic ability and participates in the development and creation of documentation used to support associated reporting and analysis.
- With mentor, learns to develop programs, time estimates, and project schedules based on prioritization and business requirements.
- With mentor, learns to monitor and create priority list(s) that are agreed to by end users and team leadership
- With mentor, learns the development of business requirements for decision support tools, reporting, and analysis.
- With mentor, assists with the development and delivery of presentations to staff and management
Level 3 - Performs job functions with general supervision- Demonstrates a thorough understanding and functional mastery of the following:
- The various areas and types of Business Intelligence reporting and analysis.
- The various reporting platforms utilized by Business Intelligence (Excel, SSRS, Tableau, Qlik Sense, etc.)
- How the Business Intelligence reporting and analysis' impact the operations and performance of the business.
- What the key departments are, their primary functions, and roles.
- The numerous systems and data sources utilized by Business Intelligence, their purpose, structure, limitations, and functional roles in Business Intelligence reporting and analysis.
- Participates in medium sized projects of moderate complexity.
- Designs, develops, and enhances moderately complex Business Intelligence reporting and analysis.
- Designs and codes moderately complex queries and data sets, using the appropriate structured programming techniques, formatting, reporting platform, and associated programming languages.
- Demonstrates functional ability to develop work-plans, write & execute unit test plans, and track & resolve any processing issues with the assistance of a mentor.
- With assistance of mentor, demonstrates functional ability to participate in requirement gathering with business partners and SME's; ensuring that requirement scoping is complete, consistent, concise, comprehensible, traceable, feasible, unambiguous, verifiably actionable, and agreed upon by all parties.
- With assistance of mentor, demonstrates functional understanding of effective design, development, and maintenance o
