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Business Analyst - Managed Care

Hospital Management Group Bakersfield, CA
  • Expired: 9 days ago. Applications are no longer accepted.

Location: Bakersfield, CA

The Business Analyst will be responsible for the extrapolation of actionable insights from sets of patient data, creating reports and data visualizations to support business decisions. The Data Analyst will use SQL queries, scripts, programming tools to support our business goals and objectives .

POSITION INTERACTS WITH:
Administration Department
UM/QM Department
Claims Department
Finance Department
Human Resource Department
Physicians
Health Plans
Vendors
Medical office staff

Job Responsibilities:

  • The Analyst works specifically in the areas of EDI and Business Intelligence. This individual should be well versed in managed care data structures pertaining but not limited to claims, eligibility, providers, vendors. Familiarity with fields on CMS and UB claim form, basic understanding of managed care workflow and how data elements relate to each other. Previous experience working with 837 EDI files, working with managed care data stored in relational databases. Ability to learn EZ-Cap data model and extract data using ad-hoc queries, firm understanding of SQL Server stored procedures, views. Report and troubleshoot technical issues, work with claim clearinghouses on sFTP and claim file transfer issues and new folder setups, aid new clients with ERA setup and inquiries. Help with creating new and editing existing Crystal Reports. Firm understanding of client/server architecture and ability to work in remote server environment.
  • Maintain all corporate enterprise Business Intelligence applications and tools.
  • Create new databases and or modify database structure(s) as needed to align to business needs of various departments.
  • Develop dashboards and data visualizations using industry standard tools to report business matrices.
  • Develop custom queries based on business needs.
  • Help prepare data marts/universes used within various departments for reporting purposes.
  • Maintains a professional relationship with providers, specialists and health plan personnel.
  • All other duties as required.

Requirements:

  • Bachelor’s degree in Computer Science (or similar area of study) and/or job experience equaling the knowledge necessary to fulfill the duties listed above.
  • Health Plan quality measure sets including HEDIS, Pay for Performance and 5-Star
  • Data analytics tools such as SPSS, Python, R , Sql Server Analysis Services
  • MUST: Experience with Citra software (EZ-CAP, EZ-CARE, EZ-EDI)
  • Microsoft SQL Server (2012 or newer)
  • Microsoft office applications and spreadsheets
  • Crystal Reports Writing

SKILLS

Able to work independently. Has knowledge of industry standards and expectations. Has knowledge of commonly used concepts, practices and procedures within this field. Excellent verbal and written skills. Computer literate with knowledge of EZ-Cap and Microsoft Applications. Relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. Works independently under the direction of the Director of Information Technology. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Job Type: Full-time

Benefits:

  • Health insurance
  • Dental insurance
  • Vision insurance
  • Paid time off

Job Type: Full-time

Hospital Management Group

Address

Bakersfield, CA
USA