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Data Analyst
1 month ago
Client: CalOptima
Job Title: Data and Reporting Analyst
Duration: 10+ Month
Start Date: ASAP
Location: 505 City Parkway West, Orange, CA 92868 (Onsite)
Position Type: Contract
Interview Type: Web Interview/ In-Person
Ceipal ID: CAL_REPO156_GM
Req ID: CalOptima Job ID
Department: Claims Administration
Description:
CalOptima Health is seeking a highly motivated an experienced TEMP - Data and Reporting Analyst - Lead to join our team. The Data and Reporting Analyst - Lead is responsible for designing, developing and maintaining databases to support business requirements of the team and continually improve data acquisition and reporting methods, which includes periodically reviewing the databases to enhance the processes and functionalities. The incumbent will assist with the development of internal systems and exception reports to ensure timely and accurate claims adjudication. The incumbent will develop and design report, create and maintain databases to support the business requirements of the team, and continually improve data acquisition and reporting methods. The incumbent will assist with the development of internal systems and exception reporting to ensure routine, timely and accurate data submissions from the health networks and to the Department of HealthCare Services (DHCS) and Centers for Medicare & Medicaid Services (CMS).
Responsibilities:
25% - Program Support Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability. Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department. Designs reports from the claims processing environment or the data warehouse; responsible for ensuring data integrity. Serves as back-up to the supervisor in their absence. Participates in progressively more complex projects and perform progressively more complex analyses.
70% - Data & Reporting Provides expertise in data analysis, including member, provider, encounters and claims data. Maintains a thorough knowledge of CalOptima Health's encounter data reporting requirements, DHCS data reporting requirements and CMS data reporting requirements. Monitors and reports on any changes that affect CalOptima Health and/or health networks. Provides guidance/development and training to other Data Analysts in the Claims department to improve the process in evaluating data and meeting customer specifications and business needs. Acts as the point of contact for data requests, assigns requests to other Data Analysts and monitors timelines and outcomes. Maintains databases to support business requirements and periodically reviews the databases to enhance the process and functionalities. Prepares ad-hoc analyses as needed. Devises and/or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time and form of desired results. Writes detailed business requirements for which technical requirements and programs will be developed. Prepares quality analytics (QA) methods to verify program and data integrity.
5% - Completes other projects and duties as assigned.
Minimum Qualifications:
Bachelor's degree in health care administration, business administration or related field required.
5 years of experience as a Data Analyst in designing, developing and maintaining databases required.
3 years of experience with structured query language (SQL) required. An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Preferred Qualifications:
3 years of experience in Information Services related to health services. Experience in an independent physician association (IPA), hospital or health plan setting. Experience with managed health care programs.
Required Licensure / Certifications: n/a
Knowledge & Abilities:
Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
Work independently and exercise sound judgment.
Communicate clearly and concisely, both orally and in writing.
Work a flexible schedule; available to participate in evening and weekend events. Organize, be analytical, problem-solve and possess project management skills.
Work in a fast-paced environment and in an efficient manner. Manage multiple projects and identify opportunities for internal and external collaboration.
Motivate and lead multi-program teams and external committees/coalitions.
Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Physical Requirements (With or Without Accommodations):
Ability to visually read information from computer screens, forms and other printed materials and information.
Ability to speak (enunciate) clearly in conversation and general communication.
Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions. Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting. Lifting and moving objects, patients and/or equipment 10 to 25 pounds Work
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V Group Inc. is an IT Services company which supplies IT staffing, project management, and delivery services in software, network, help desk and all IT areas. Our primary focus is the public sector including state and federal contracts. We have multiple awards/ contracts with the following states: AR, CA, DE, FL, GA, IL, KY, MD, ME, MI, NC, NJ, NY, OH, OR, PA, SC, TX, VA, and WA. If you are considering applying for a position with V Group, or in partnering with us on a position, please feel free to contact me for any questions you may have regarding our services and the advantages we can offer you as a consultant.
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