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Data and Reporting Analyst

1 month ago

Orange, United States INSPYR Solutions Full time

Title: Data and Reporting Analyst - Lead (Claims)
Compensation: $48.03-$76.84/hr based on experience (Salary Schedule: $96,000/yr - $152,000/yr)
Duration: 6 month contract (on site)
Experience: 5+ years Data Analysis, 3 yrs with SQL, preferred experience in Managed Health Care
Work Requirements: US Citizen, GC Holders or Authorized to Work in the U.S.

Job Summary
Our client in Orange, CA, is seeking a highly motivated an experienced Data and Reporting Analyst – Lead to join their team (contract).  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). 

Department: Claims Administration
Work Arrangement: Full in Office, Mon - Fri

Duties & 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 CLIENT’s Health’s encounter data reporting requirements, DHCS data reporting requirements and CMS data reporting requirements. Monitors and reports on any changes that affect CLIENT 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 CLIENT’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 
 
If you are interested and qualified, please send your resume (Word Format Only) to Michelle Nicolaus at mnicolaus@inspyrsolutions.com.

Our benefits package includes:

  • Comprehensive medical benefits
  • Competitive pay, 401(k)
  • Retirement plan
  • …and much more

 
About INSPYR Solutions

Technology is our focus and quality is our commitment. As a national expert in delivering flexible technology and talent solutions, we strategically align industry and technical expertise with our clients’ business objectives and cultural needs. Our solutions are tailored to each client and include a wide variety of professional services, project, and talent solutions. By always striving for excellence and focusing on the human aspect of our business, we work seamlessly with our talent and clients to match the right solutions to the right opportunities. Learn more about us at inspyrsolutions.com.
 
INSPYR Solutions provides Equal Employment Opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, INSPYR Solutions complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities.

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