Responsible for all data reporting and analysis functions for the Network Management department, including developing, designing, and maintaining databases. Develop and design reports to assist with the routine operational requirements of the department. Produce ad hoc reports as necessary in response to requests by senior management, the Board of Directors and as required by the Department of Health Care Services (DHCS). Provide data analysis and reporting as required in support of major CalOptima initiatives.
POSITION RESPONSIBILITIES:
- Designs reports from FACETS and/or Cactus as needed in order to ensure data integrity.
- Maintains a thorough knowledge of CalOptima’s DHCS and/or CMS data reporting requirements and produce reports for DHCS accurately and on a timely basis.
- Produces provider accessibility reports utilizing FACETS data and Quest Analytics software.
- Maintains and modifies current databases used by the Network Management staff based on staff feedback.
- Analyzes data, identifies data inconsistencies, and provides feedback to resolve issues.
- Produces provider directories as required for all CalOptima’s lines of business.
- Uploads and provides reporting on Health Network member PCP data.
- Responds to ad hoc reporting requests.
- Responds to requests from departments to enable the faxing of information to constituents.
- Produces Board of Directors conflict of interest reports to be used in conjunction with the monthly BOD meetings as needed.
- Other projects and duties as assigned.
Required Skills
- Develop and maintain thorough knowledge of data sources used for reporting.
- Develop and maintain knowledge of CalOptima’s lines of business and health networks.
- Work independently and as part of a team under minimal supervision.
- Develop and maintain effective, productive working relationships with all levels of staff.
- Work on complex projects and perform senior-level data quality analysis.
- Present information in a useable format and be able to clearly explain the content.
- Prioritize tasks and use time efficiently.
- Communicate clearly and concisely, both verbally and in writing.
- Utilize computer and appropriate software (e.g. Microsoft Office; Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
Required Experience
EXPERIENCE & EDUCATION:
- Bachelor’s degree in Health Care Administration, Business Administration or other related field, and/or relevant experience in data reporting and analysis and/or developing, designing, and maintaining databases, is required.
- 3 years of health care background experience required.
- 3 years of experience working as a data analyst, preferably in health care, required.
KNOWLEDGE OF:
- SQL and VBA.
- MS Access to create ad hoc reports and design databases.
- Microsoft Excel to manipulate data and produce charts/reports applicable to reporting requests.
- Quest Analytics to develop reports to analyze provider adequacy and accessibility.
- Tableau software for creating dashboard type of reporting for Network Management.
- Managed care concepts.
- Medicare/Medi-Cal guidelines, regulations and data reporting requirements preferred.
Grade: M
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