This position will support the risk adjustment program as part of the implementation of the requirements of the Affordable Care Act overseen by the Actuarial Department. The incumbent will be responsible for the planning, development, analysis, and implementation of procedures and/or processes to ensure accurate claims and enrollment data are submitted to the government;
Primary duties may include, but are not limited to:
Support and experience full project / software development lifecycle
• Analyze business requirements and assist in designing business solutions
• Perform unit acceptance testing of solutions developed by IT team
• Perform post-implementation verification after project deployment
• Write SQL queries to illustrate the issue or test the solutions
• Assist in the documentation of business processes
Develop and maintain optimized data warehouses
• Design and develop data warehouses on Teradata using utilities such as Fast Load, Multi Load, Fast export, TPump and BTEQ.
• Use SQL programming (DDLs, DMLs, aggregate/window aggregate/ordered analytical functions) in the creation and maintenance of the data mart
• Use complex correlated subqueries, recursive queries, stored procedures to support the data mart
Develop and maintain management reporting dashboards
• Write SQL queries to generate the output for the reporting dashboards
• Optimize or enhance the reporting dashboards using VBA programming or Python scripts
Perform data analysis, data profiling and research to support business initiatives or solve data issues
• Perform root cause analysis of errors and recommend solutions
• Manipulate large data sets and interpret results using data aggregation functions
• Validate data to ensure accuracy, quality and integrity
Collaborate with internal and external partners in establishment, design and execution of business rules
Demonstrate ownership and accountability on assigned projects
Work with minimal supervision
Contribute to best practices.
Bachelor Degree in Business Administration or Computer Science.
4 years of information technology experience working on mainframe systems.
4 years of experience with relational database technology.
4 years of experience in a job requiring analysis with healthcare information data analysis.
Min 4 years of USA experience with SQL, Access, APL or other relational database systems tools.
4 years of experience in system development and programming.
Clear and concise verbal and written communication skills.
Advanced SQL programming skills.
Strong analytical and problem-solving skills
Experience in data analysis and analytical reporting
Experience with Teradata or other database systems
Experience in database design/development, database administration, and business intelligence
Ability to communicate ideas and results effectively
Proficiency with advanced Excel features and techniques; VBA skills desired
Strong leadership and collaboration skills
Ability to manage conflicting priorities and multiple projects concurrently
ACA claims/membership experience
Familiarity with agile/scrum or other project methodologies
Experience with dataset application programming (Python) desired
Experience or understanding of Jira and/or GitHub
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|Years of Experience ||5+ to 10 years|
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|Willingness to Travel||-|
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