Managed Care Data Analyst

Job description

·  Job Description:

The Managed Care Data Analyst is responsible for analyzing the managed care provider network data, performing research and audits, and providing information to the State for the purpose of determining if the Managed Care Organization’s Provider network is meeting contractually required access and availability standards.

·  Duties and Responsibilities (List all essential duties and responsibilities in order of importance)
·  Develops queries, macros and prepare reports with metric/data analysis based upon data related to the Managed Care Organizations
·  Designs and develops audit tools that can interface with existing data sources utilizing applications such as MS Excel, Access, or SQL database functions
·  Perform data audits utilizing developed business requirements
·  Designs, implements and maintains all functions of database including access, validation checks, organization, security and documentation.
·  Develops, prepares, and ensures all reports are completed accurately and timely
·  Interfaces with customer as needed.
·  Provides support to the customer, such as, Access or SQL database function, GIS (Quest Analytics), GeoCoding software.

·  State Plan / Department Specific Duties and Responsibilities (List all essential duties other than those listed above in order of importance)
·  Captures and houses all Managed Care Network data.
·  Utilizes State approved GIS (Geographic Information System) to perform the tasks.

·  Knowledge, Skills and Abilities ( List all knowledge, skills and abilities that are necessary to perform the job satisfactorily)
·  Must be highly analytical and detail oriented with ability to problem solve
·  Proficient working knowledge of Microsoft Office products
·  Good working knowledge of GIS and GeoCoding tools
·  Excellent verbal and written communication skills
·  Ability to abide by DXC policies
·  Ability to maintain attendance to support required quality and quantity of work
·  Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
·  Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
·  Provides Access or SQL database support to other work units as assigned or needed.

·  Education and Experience
·   Bachelors Degree or equivalent experience
·  3 years in Healthcare Industry
·  Proficient with Microsoft Excel
·  1 year experience using GIS tool (Quest Analytics) preferred