Healthcare EDI Analyst jobs in District of Columbia

CINQCARE

Senior Healthcare Economics Data Analyst

Position Description

Overview

The Senior Healthcare Economics Data Analyst reports to the Senior Vice President of Healthcare Economics and Analytics, CINQCARE, Inc., with accountability for data analytics support for the company’s ACOs (with particular attention on CMS’s ACO REACH model) and value-based care initiatives.  This position is primarily responsible for providing analytical via the development of reporting solutions and decision analysis from a variety of data sources.  The analyst will perform research and analysis of multiple data sources, including clinical and claims data, to meet business performance reporting needs.  The analyst will be required to effectively communicate key findings to the executive team and support to the President ACOs and Value-Based Care Innovations, CINQCARE, Inc., and assist in presenting the results to wider audiences as applicable. The analyst must possess solid research skills, excel at written and verbal communication, and have the proven ability to manage multiple assignments of varying depth and duration. The Sr HCE Data Analyst should embody CINQCARE’s core values, including Trusted, Empathetic, Committed, Humble, Creative and Community-Minded. At CINQCARE, we don’t have patients or customers – we have Family Members.

Job Responsibilities

The Sr HCE Data Analyst will have the following responsibilities:

• Interface, coordinate with, support and be accountable to the President, ACOs and Value-Based Care Innovations, CINQCARE, Inc.
• Use quantitative and data science skills, collect, manage, analyze, and assess data of multiple types and sources related to CINQCARE ACOs and value-based care initiatives.
• Manage file transfer from the CMS 4i system, file processing, and file ingestion into SQL Server environment.
• Provide subject matter expertise support to data architect and developers regarding data integration, data warehousing, modeling, database, and technical aspects of reporting via business intelligence tools.
• Provide oversight of data quality and provides feedback to various areas to improve service delivery and enhance operational design efforts.
• Document reporting parameters and maintains version controls.
• Create queries of moderate complexity using T-SQL and other query languages, ensuring data accuracy and that results meet intended requirements.
• Compile, manipulate, and analyze CMS CCLF and related claims files to identify trends and variances for patients receiving medical care.
• Support the transformation of raw data into valuable and meaningful insights in the form of appealing dashboards and reports via both Power BI and advanced Excel applications (e.g., levering external PowerShell scripts).
• Prepare ad hoc reports from clinical and/or financial data, using Microsoft Office applications including Word, Access and Excel, Tableau, and other similar business intelligence tools to meet business and clinical performance reporting needs.
• Provides analytics that support new approaches to system-wide models for delivering health care and improving the health of populations including Accountable Care Organizations models and shared savings programs.
• Stay current with updates on technology tools and available data sets relevant to programs of interest to CINQCARE and the use of various analytic techniques.
• Perform other job-related duties.

General Duties

The Sr HCE Data Analyst will have the following duties:

• Leadership: The Sr HCE Data Analyst will lead in defining and executing strategies and solutions to create business value for CINQCARE, including collaborating with their team to design, develop, and execute those strategies and solutions to deliver desired outcomes.
• Strategy: The Sr HCE Data Analyst will establish the business strategy and roadmap: (1) improve outcomes for CINQCARE Family Members; (2) enhance the efficacy of other CINQCARE business divisions; and (3) develop and deliver external market opportunities for CINQCARE products and services. In establishing the business strategy, the Sr HCE Data Analyst will define and innovate sustainable revenue models to drive profitability of the Company.
• Collaboration: The Sr HCE Data Analyst will ensure that CINQCARE’s capabilities form a cohesive offering, including by working closely with other business divisions to learn their needs, internalize their knowledge, and define solutions to achieve the business objectives of CINQCARE.
• Knowledge: The Sr HCE Data Analyst will provide subject matter expertise in Medicaid, Medicare, and dual eligible solutions, including determining and recommending approaches for mitigating risk solution deployment and performance evaluation.
• Culture: The Sr HCE Data Analyst is accountable for being hands-on in the field and for creating a productive, collaborative, safe and inclusive work environment for the team and as part of the larger Company. The Sr HCE Data Analyst demonstrates a willingness to listen effectively and communicate with respect, thoughtfulness, and transparency.

Qualifications

The Sr HCE Data Analyst should have the following qualifications:

• Education/Experience:
  • Bachelor’s degree in Computer Science, Business, Economics, or Healthcare Administration or related field; Master’s degree preferred.
  • At least 3 years’ experience with relational databases, report building and or data analysis is required.
  • Experience with clinical applications such as electronic medical records preferred.
  • At least 3 years of experience working with healthcare analytics projects using medical claims data is preferred.
  • Experience working with Medicare data is strongly preferred.
  • Experience with CMS CCLF sources, HCC risk coding, and shared risk/savings contracts strongly preferred.
  • Experience with CMS 4i system is strongly preferred.
  • Understanding of, and familiarity with, accountable care organizations preferred.
• Computer Knowledge:
  • An advanced level of proficiency working with Microsoft Office Tools (Excel, Word, PowerPoint etc.) is required.
  • Experience using SQL, SQL Server, and T-SQL is required.
  • Previous experience automating processes and securely transmitting data via SFTP using command scripts is strongly preferred.
  • Advanced Excel skills levering external PowerShell scripts is strongly preferred.
  • Experience with PowerBI is preferred.

• Entrepreneurial: CINQCARE seeks to fix gaps that have persisted for generations in the delivery of care to Black and Brown populations. This position is accountable for ensuring CINQCARE is positioned to innovatively deliver on its promise.
• Communication: Excellent verbal, written, presentation, and group facilitation skills; ability to clearly articulate and present concepts and models in an accessible manner to CINQCARE’s team, partners, and other stakeholders. Must have strong critical analytic, thinking and communication skills necessary to evaluate and respond to team progress, anticipate needs and other related team dynamics.
• Professional Demeanor: Ability required to collaborate in a matrixed environment with a strong focus on the attainment of organizational goals and objectives through a commitment to teamwork. Expert problem-solving skills, attention to detail, working against deadlines and communicating status of project, and natural curiosity and drive towards understanding the health trends of a population. Excellent oral and written communication skills including the ability to present complex information effectively with a wide range audience. Ability to prioritize multiple projects and assignments; work independently as well as in a team environment; and deal effectively with complex assignments and essential projects.
• Culture: Good judgement, impeccable ethics, and a strong team player; desire to succeed and grow in a fast-paced, demanding, and entrepreneurial Company.

Location: D.C

Compensation: $85,000-$95,000