The Enterprise Data Management team is looking for a System Analyst II for the risk adjustment submissions team. The analyst will be responsible to loading, monitoring, and researching data in the Medicare and commercial risk adjustment processing systems. Analyst will represent the Enterprise Data Management team in meetings with internal and external teams to discuss research and analysis. Strong analysis and communication skills are required for this position.
Principal Responsibilities and Essential Duties:
- Analytics: Uses analytical and development skills in mining a multi-terabyte environment for opportunities in furthering the detection of errors and abuse in client integrations. Uses assessment skills to research and analyze the business opportunities of the clients; making reasoned decisions after assessing the circumstances, and then provides recommendations along with risks and issues involved with each alternative to clients. Sales Support: Works with potential clients in a pre-sales environment to define requirements, processing clients’ data, and work with sales staff to present analytics and ConVergence Point results.
- Requirements capture and analysis: Works with clients, consultants, vendors, and internal development and operations staff to develop implementation requirements. Models processing workflows and provides data integrations using leading edge integration technologies.
- Systems: Works with internal/development staff to resolve system fixes/updates and customer requests and issues. Uses healthcare domain expertise to provide suggestions for product enhancements and future version development. Provides direction in customer configuration requirements, work plan development, and programming requirements to ensure ConVergence Point service meets market requirements and implementation needs.
- Operational Support: Provide on-call support for a shift time period in a 24x7 environment on a rotational basis. Typically, every 4-6 weeks.
- Integration Support: Documents, implements, oversees and tests the successful integration of the ConVergence Point service. Participates in processing of client data and presentation of findings to client. Helps to coordinate scheduling of the preparation and integration of client data into the production environment with internal groups.
- Tool Development: Supports and extends a wide variety of internal and external tools used within the ConVergence Point service model.
- Completes all responsibilities as outlined on annual Performance Plan.
- Completes all special projects and other duties as assigned.
- Must be able to perform duties with or without reasonable accommodation.
- Position requires a bachelor's degree typically in Computer Science and 6 to 8 years of relevant experience.
- 4 + years Programming experience using SQL, Oracle PL/SQL, and a scripting language.
- 5 + years’ experience with the Microsoft office suite of products; experience with Word, Excel, and Access preferred.
- 4 + years’ experience dealing with multi-terabyte data warehousing environment, OLAP and decision support tools a plus
- 4 + years ETL (Oracle SQL Loader, Microsoft SQL DTS Packages, etc.)
- Experience in healthcare or health insurance industry
- Strong time management skills, including the ability to work independently and balance daily operations and projects
- Knowledge and awareness of standard IT practices for quality control and audit trails
- Low to Midlevel programming skills with a 3rd generation programming language
- Ability to create functional specifications consumable by software developers
- Customer service orientated with strong communication skills
- Strong problem solving and analytical skills
- Report development experience (i.e. MS Access, Crystal Reports, Business Objects, Cognos.)