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Lead Data Analyst

3 months ago

New York, United States EmblemHealth Full time

Summary:

Manage complex analyses and reporting of All Payer Database (APD), and MMCOR responses to/from State of NY, and correction data. Plan and execute projects including building repeatable SAS projects, train less experienced team members in SAS. Review APD submissions and make necessary enhancements to improve MMCOR accuracy, speed, and better visualizations.


Responsibilities:

  • Develop and maintain business process and technical workflow documents for State filing APD data submission.
  • Prepare process documentation to verify/validate workflow capture accuracy.
  • Assist with Government audits and reporting responses.
  • Develop improved monthly reporting packages; lead discussions with management on the metrics/trends.
  • Perform root cause analysis to identify issues that can be remediated with coding/processing rules updates.
  • Monitor changes from the State of NY, attend State meetings, analyze potential/actual impact(s) and participate in requirements to ensure compliance with regulations.
  • Complete design reviews from the business perspective to ensure that are compliant and maximize State submissions and serve as the lead signoff resource.
  • Maintain industry level knowledge of trends, practices, digital design software, etc.


Qualifications:

  • Bachelor’s degree
  • 5 – 8+ years of relevant, professional work experience required
  • 3+ years of complex data analysis, preferably in a healthcare provider/insurance environment or company required
  • Demonstrated proficiency in systems applications such as SAS, ACCESS, Microsoft Excel, ORACLE, SQL and Crystal Reports and other analytic and reporting packages to lead and direct programming work in the department required
  • Knowledge of file structure and information systems sufficient to design and develop info reporting and analysis systems required
  • Analytic skills to design process improvement initiatives; ability to prepare written/multimedia presentation of results required
  • Excellent communication skills (verbal, written, presentation, interpersonal) with all types/levels of audiences required
  • Project management, including SDLC experience required