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Encounters Data Analyst III

Role overview

Qualifications

  • Bachelor’s Degree or equivalent years of relevant work experience
  • Minimum of six (6) years of experience in data analysis or equivalent analytic experience
  • Experience in data mapping
  • Experience with Pharmacy and/or Medical Claims/Encounters data analytics

Responsibilities

  • Identify and quantify data issues within the organization and assist in the development plans to resolve Claims Encounters data issues
  • Guide, mentor, and instruct more junior staff members as they perform Claims Encounters data analysis
  • Support regular Claims Encounters data management processes and ad hoc requests
  • Monitor the quality of encounter data submitted to regulatory agencies

Key facts

Other skills

  • Microsoft Excel
  • Communication
  • Teamwork
  • Problem Solving
  • Customer Service

About the company

CareSource logo

CareSource

Health Insurance (Payers)

Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits. CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve. CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf Si usted o alguien a quien ayuda tienen preguntas sobre CareSource, tiene derecho a recibir esta información y ayuda en su propio idioma sin costo. Para hablar con un intérprete, Por favor, llame al número de Servicios para Afiliados que figura en su tarjeta de identificación. 如果您或者您在帮助的人对 CareSource 存有疑问,您有权 免费获得以您的语言提供的帮助和信息。 如果您需要与一 位翻译交谈,请拨打您的会员 ID 卡上的会员服务电话号码。

Company details

Company typeLarge
IndustryHealth Insurance (Payers)
Company size1001 - 5000

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Job description

Job Summary:

Encounters Data Analyst III is responsible to perform analysis of all data into, out of and within CareSource in support of Encounters Revenue and Remediation efforts.

Essential Functions:

  • Identify and quantify data issues within the organization and assist in the development plans to resolve Claims Encounters data issues
  • Guide, mentor, and instruct more junior staff members as they perform Claims Encounters data analysis
  • Support regular Claims Encounters data management processes and ad hoc requests to support internal, State and Federal, or fiscal agent’s data requests
  • Monitor the quality of encounter data submitted to regulatory agencies
  • Supports the verification of Claims Encounters data accuracy within source systems
  • Supports the maintenance of the Analytic Systems data dictionaries
  • Develop, document, and perform testing and validation as needed
  • Assist in ETL development, documentation and testing as needed
  • Work with SMEs to develop business rules that support the transformation of data
  • Facilitate discussions between end users and data modelers as needed
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s Degree or equivalent years of relevant work experience is required
  • Minimum of six (6) years of experience in data analysis or equivalent analytic experience is required
  • Experience in data mapping required
  • Experience with Pharmacy and/or Medical Claims/Encounters data analytics is required
  • Healthcare experience preferred

Competencies, Knowledge and Skills:

  • Proven understanding of database relationships
  • Proven programming skills with emphasis on mining/manipulation
  • Advanced MS Excel and/or Access
  • SAS experience preferred
  • SQL experience required
  • Tableau/ Power BI preferred
  • Communication skills both written and verbal
  • Ability to work independently and within a team environment
  • Critical listening and thinking skills
  • Decision making/problem solving skills
  • Excellent customer service skills

Licensure and Certification:

  • SAS Certifications preferred
  • SQL Certifications preferred

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$83,000.00 - $132,800.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Fostering a Collaborative Workplace Culture

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business


 

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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Marcus Rivera

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