THIS IS AN ON-SITE POSITION. MUST BE ABLE TO BEGIN RIGHT AWAY.
Candidate MUST HAVE experience building relational databases for data manipulation.
Responsibilities
Responsible for gathering and translating business requirements into data queries (SQL), models, and tools to allow for insightful data analysis
Create and maintain databases in Microsoft Access; develop, maintain or implement procedures for data entry, data cleaning, documentation and other administrative tasks
Generate and manage monthly Executive Summary and high-level Microsoft Excel reports generated from internal and external sources
Interface with QNXT Production Support (QPS) on development and testing of new reports; interact with EAST Team to facilitate new requirements and change requests (i.e. Fee schedule, benefit, code updates)
Troubleshoot reports and letter generation issues; provide updates to management, resolve or document problems; partner with Information Technology, ETL and QNXT (EAST) teams to resolve issues
Communicate with internal departments and vendors to identify and resolve issues
Audit inquiries from Utilization Management (UM) systems (i.e.QNXT, ICIS, Actuate, ICMS) for accuracy of content and compliance (UM requests/determination letters, Appeals/Inquiries)
Assist Care Management staff with difficult issues and resolve problems; assist Supervisor in development of process improvements tools and staff training
Perform, research, and summarize findings; download and prepare reports abstracted from external vendors' reporting systems as needed; conduct testing on system enhancements
Perform additional duties and projects as assigned by management
Qualifications
Bachelor's degree in Computer Science required
Minimum three (3) years experience managing relational databases to include database management and data analysis required
Experience with care management, health insurance, or health claims preferred
Experience writing system specifications, expert knowledge of relational database concepts and facility with SQL (i.e. queries, tables, forms, and reports)
Demonstrated experience in data analysis and reporting required; able to identify anomalies, trends, inconsistencies and make recommendations to improve processes, workflow and operations
Advanced skill level in Microsoft Access and Excel required; excellent working knowledge of database tables, forms, queries and reports a must
Knowledge of Medical, Hospital, Eligibility processing systems (i.e. V3, QNXT) and utilization management systems (ICIS, Actuate, ICSM) highly preferred
Strong critical thinking and analytical skills required; must be an effective problem solver
Able to work well in a fast-paced environment with competing priorities and strict timelines
Excellent time management and project management skills; able to prioritize and multi-task
Detail oriented with the ability to work well independently and as a team player
Excellent verbal and written communication skills a must
Must meet performance standards including attendance and punctuality