Utilization Management Data Analyst (Remote Option)

Competitive Compensation & Benefits Package!  

Position eligible for – 

• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs

See attachment for additional details. 

Location:   Remote Option; Flexible for any of our office locations in NC

Projected Hiring Range:  Depending on Experience

Closing Date:  Open Until Filled

Primary Purpose of Position:  This position will provide data support to the Utilization Management (UM) Department.  Work involves data entry and analysis, data mining, data management, reporting, record keeping, and providing and coordinating the provision of a full range of support activities necessary for the effective management of the data for the department.   Position uses various tools and software including but not limited to Alpha+, NCTRACKS, Power BI, Data Cubes and TruCare. 

Role and Responsibilities:  

Extrapolate data for monthly reports, provide preliminary data analysis, and enter and maintain data in all applicable systems and/or databases as per established practices, processes and protocols. It is also essential that all record keeping and data sharing be timely and well documented.  Types of data management include, but not limited to the following: 

• Importing, exporting and extrapolating data from systems
• Management of UM Databases
• Prepare & manage caseload productivity reports for UM
• Run/preparation of Service/Utilization Reports 
• Assist in research of incident report data
• Extrapolate data for state monthly reporting
• Extrapolate data/run reports for performance requirements (list assigned by directors)
• Design reports for internal and external recipients, which may require independent research
• Work with Clinical Analyst, IDD Special Projects & Data Specialist to compile and analyze clinical documentation for audit review & quality improvement
• Works independently and with others to develop accurate and useful reports, tools, and resources to promote a qualitative and quantitative data driven organization  
• Produce and examine reports, gather and coordinate submission of State reports as mandated
• Assists supervisor in assuring the integrity of systems used in data collection, analysis and interpretation of information, accuracy of reports through data validation, and that projects are completed within established guidelines, including established timeframes
• Respond to requests from other Partners staff, particularly concerning UM data needs

Knowledge, Skills and Abilities: 

• Strong, working knowledge of data extraction methodologies
• Ability to exercise appropriate judgement and discretion in presenting data
• Ability to present complex data and information to varying audiences, both internal and external, in a professional and clear manner.
• Knowledge of program practices, techniques, and technology sufficient to support the program
• Knowledge of the goals and objectives of the work unit and an understanding of the structure and functions of the organization (must have knowledge of staff assignments/commitments, and the functions of other internal and external organizational segments whose work impacts on the unit or with which work must be interfaced)
• Excellent computer skills; proficient in Microsoft Office Products (Word, Excel, Outlook, Publisher); experience in use of databases
• Ability to practice effective communication techniques, oral and written
• Ability to establish and maintain effective interpersonal and working relationships with internal and external customers
• Ability to analyze and interpret policy and procedural guidelines and to resolve problems and questions, independently
• Ability to complete non-routine activities and tasks that require deviation from established procedures which includes the ability to choose the appropriate course of action and recognize the existence of and differences among situations
•  Ability to use initiative and judgment in resolving problems not covered by established priorities or prior experience
•  Ability to recognize sensitive or unusual situations that should be referred to another more appropriate staff member or to the supervisor
• Ability to manage and uphold integrity and confidentiality of sensitive data

Education and Experience Required: Bachelor’s Degree and two (2) years of experience in statistical reporting and/or analysis or an equivalent combination of education and experience.  

Education and Experience Preferred: Bachelor’s Degree with a concentration in statistics, data management or related area and two (2) years of experience in collecting and reporting statistical data in a Human Service/healthcare setting. Experience with LME/MCO system preferred.