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Healthcare Analyst - Encounters Data

Job Category: Data Analysis / Business Intelligence

Location: New York, NY, United States

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Job Description

Description

The Healthcare Analyst – Encounters Data in Finance will support the department in performing functions that enable key business processes and practices. Encounter data is detailed data generated by health care providers, such as doctors and hospitals, that documents both the clinical conditions they diagnose as well as the services and items delivered to beneficiaries to treat these conditions. Encounter data is the main driver of risk adjusted revenue for New York State (NYSDOH) and the Center for Medicare Services (CMS). The incumbent will be passionate about data integrity and work well with a dedicated team of professionals. This is a great opportunity to apply an advanced technical skillset while learning about many different aspects of the healthcare industry.

Opportunity for Incumbent:

  • Ability to create new processes and build lasting relationships.
  • Get involved in all aspects of the healthcare industry, particularly how data drives decision making.
  • Apply data science and “big data” methods using advanced technology.
  • Satisfaction that the work you do can lead to such things as fraud detection, early intervention, higher quality care and improving chronic disease management.

Duties/Responsibilities:

  • Support the production of encounter data submissions to NYSDOH/CMS.
  • Filter and “clean” data by creating and maintaining reports that to improve encounter submission accuracy.
  • Create documentation to satisfy regulatory requirement for internal and external auditing.
  • Remediate issues by organizing and leading meetings with internal and external stakeholders.
  • Collaborate with Information Technology (IT) to create new enhancements and upgrade production processes.
  • Create dashboards displaying key encounter data metrics using Excel or Tableau to be presented to executive leadership.

Minimum Qualifications:

  • Bachelor's degree from an accredited institution.
  • Working knowledge of SQL or SAS (Base SAS or SAS Enterprise Guide).
  • Experience with large data sets in a data warehouse environment.
  • Advanced understanding of Excel, including VLOOKUP, as well as pivot tables.
  • Ability to communicate effectively and work well in a team-oriented environment.

Preferred Qualifications:

  • Master's degree from an accredited institution.
  • Analytical work experience within the healthcare industry.
  • Experience with claims data, encounter data or risk adjustment.
  • Knowledge of Visual Basic for Applications (VBA).
  • Understanding of Medicaid and Medicare programs.
  • Managed care experience with a focus on claims, encounter data or risk adjustment.
  • Knowledge of Python, R, or SQL Server.
  • Has worked with EDI files such as X298, X299, NCPDP 4.2, 837I, 837P.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

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