Encounters System Analyst II – Vendor

Job Description: • Perform analysis of Encounter data • Understand the financial and clinical impact of changes and decisions to the business process to ensure that the Service Level Agreements (SLAs) are achieved • Support for Regulatory Data projects • Responsible for reviewing Encounter rejections and providing resolution of minor to complex data issues or process changes • Support for Claims Encounter Subject Matter Expertise (SME) for both CMS and State agencies and internal CareSource impacted organizations • Build, sustain and leverage relationships with persons within his/her area of responsibility to allow for continuous improvement of the Encounter Data business process • Support for testing and delivering process to business • Participate in claims data processes to ensure accuracy and compliance with CMS and state agencies • Participate in the key claims data management and readiness to state and governing entities • Understand the Claims Encounter Data requirements in detail Requirements: • Bachelor’s degree in Science/Arts or equivalent years of relevant work is required • Master’s Degree in Science/Arts preferred; concentration in Healthcare Analytics or Data Science preferred • Minimum of one (1) year to two (2) years of managed healthcare, claims, or managed care regulated environment experience is required • Minimum of one (1) year of experience using at least two of the following tools is required: SQL, SAS, SSIS. MySQL, ORACLE, R, or PowerBI Benefits: • Comprehensive total rewards package • Bonus tied to company and individual performance Apply tot his job