Under the direction of the Director, Health Services Reports & Controls this position is primarily responsible to support the creation, maintenance, and data integrity of the Health Services (HS) operational report suite. This role is responsible to coordinate efforts that ensure that HS new and existing business operational reports are developed and distributed accurately and timely.

Core Responsibilities:

• Acts as a primary point-of-contact for HS standard new business monitoring and trending reports including data elements or algorithm modifications to align with State specific requirements.
• Ensures HS operational production reports for new business are established and deployed in alignment with Health Plan go-live – including creation of a pre-work processes.
• Translates contractual service level requirements to functional specifications and engages the appropriate subject matter experts to ensure internal management reports comply with state reporting instructions.
• Monitors and audits operational reports to ensure accuracy and integrity of data - proactively communicates identified issues up and across.
• Interprets complex problems or projects where analysis of situations or data requires an in-depth evaluation of multiple factors.
• Demonstrates strong problem solving capabilities and approaches each problem in a logical and analytical manner with a high degree of resolve.
• Collaborates with internal and external business areas to maintain a current working knowledge of contractual, regulatory, internal, and informational service levels and other requirements (e.g., accreditation, legislative).
• Active participant in cross-functional projects or workgroups to assess impacts to HS reporting including new report development, data or rule changes, parameter modifications, assumptions, and process amendments.
• Communicate with stakeholders to determine appropriate course of action prior to enacting changes in reporting processes.
• Completes special projects, adhoc & priority reporting, and other duties as assigned.
• Adept at managing multiple priorities under time constraints.

Education & Experience:

• 3 to 5 years healthcare experience with specific experience in data analysis and reporting.
• Bachelor’s Degree or equivalent work experience.
• Ability to analyze large data sets and make defensible recommendations.
• Ability to engage and communicate with individuals at all levels.
• Demonstrated ability to function autonomously and as part of a team.
• Excellent organizational, analytic, and interpersonal skills required.
• Prior experience working with and analyzing large data sets required.
• Clear working knowledge of MS Office Suite required.
• Previous experience with the Facets claims system preferred.
• Knowledge of SQL queries, SQL Servers, Oracle Databases preferred.
• Previous experience with SharePoint preferred.