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Compliance Data Analyst II (Health Plan/MCO experience)

Role overview

Qualifications

  • Bachelor’s Degree or equivalent years of relevant work experience
  • Minimum of three (3) years of experience in data analytics
  • Healthcare and/or Compliance experience is preferred
  • Understanding of database relationships

Responsibilities

  • Develop, design, and maintain technology solutions and workflows to support ethics and compliance processes
  • Develop routine operational/analytical reports for management of Compliance processes and functions as needed
  • Identify and resolve data quality issues within compliance tools and reporting
  • Represent the compliance department in project meetings and other meetings that require subject matter knowledge and input

Key facts

Hard skills

Other skills

  • Microsoft Excel
  • Critical Thinking
  • Decision Making
  • Problem Solving
  • Communication
  • Collaboration
  • Teamwork

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:

The Compliance Data Analyst II is responsible for managing ethics and compliance technology and develop reporting to meet the information needs of the compliance organization.

Essential Functions:

  • Develop, design, and maintain technology solutions and workflows to support ethics and compliance processes
  • Develop routine operational/analytical reports for management of Compliance processes and functions as needed
  • Work with business areas to identify and implement opportunities for improvement that impact compliance through the delivery of appropriate reporting and data
  • Identify and resolve data quality issues within compliance tools and reporting
  • Generate graphics that effectively describe, explore and summarize compliance data
  • Incorporate critical thinking skills and judgment in the process to determine best course of action for each inquiry/problem
  • Investigation of compliance data that shows a pattern or indicates a significant variation from expected
  • Represent the compliance department in project meetings and other meetings that require subject matter knowledge and input
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s Degree or equivalent years of relevant work experience is required
  • Minimum of three (3) years of experience in data analytics
  • Healthcare and/or Compliance experience is preferred

Competencies, Knowledge and Skills:

  • Understanding of database relationships
  • Advanced MS Excel, Power Query, Power Pivot, Formula Development skills 
  • SharePoint and Nintex workflow development skills
  • Knowledge of working with Power BI and ServiceNow
  • Graphic development/presentation skills
  • Critical listening and thinking skills
  • Decision making/problem solving skills
  • Communication skills both written and verbal
  • Ability to work independently and within a team environment
  • Knowledge of managed care preferred

Licensure and Certification:

  • None

Working Conditions:

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

Compensation Range:

$72,200.00 - $115,500.00

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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