SDS Business Analyst - Entry

  • location: Hopkins, MN
  • type: Contract
  • salary: $18 - $21 per hour
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job description

SDS Business Analyst - Entry

job summary:
The SDS Business Analyst will be responsible for management of supplemental data sources (SDS), including audit documentation, HEDIS® technical specification review, and tracking of supplemental data sources.

This role requires collaboration with appropriate areas of the business to ensure the most efficient management of data with the highest level of quality and greatest Enterprise gain.

All work supports Commercial, Medicare & Medicaid lines of business. Additionally, this role will support process improvement through the identification of data source opportunities for improvement and development of associated action plans.

*The position is able to telecommute, however, work hours are either Central or Eastern Time zones.

Primary Responsibilities:

Source Management

- Knowledgeable of supplemental data sources - purpose, intent of use, data collection method

- Responsible for audit documentation completion and quality of documentation

- Responsible for medical record requests to support medical record review or primary source verification - related to HEDIS® audit

- Knowledgeable of NCQA HEDIS® technical specifications regarding supplemental data and applicable measures

- Responsible for tracking of source documentation readiness

Data Management

- Maintain documentation of end-to-end data flow of sources

- Knowledgeable of data validation reports of sources

- Awareness of data load to HEDIS® rules engines

Audit Management

- Maintain documentation of audit review outcome by source

- Support Quality Solutions Delivery with HEDIS® audit - for all audit groups involved with annual audit -- address audit issues/concerns within required turnaround time

- Complete work on time, especially as it pertains to HEDIS® audit deadlines

Other Responsibilities:

- Develop & produce ad-hoc reports

- Participate with complex analyses and reports

- Works independently; seeks guidance on only the most complex tasks

- Works collaboratively with other CDSM team members, Quality Solutions Delivery, SDR and PEDS teams

- Support national projects /pilots

Qualifications:

- 4+ years of experience with HEDIS® documentation and auditing processes

- 2+ years' experience in Healthcare Industry with clinical data (non-claims), with a focus with understanding of medical terminology and clinical care

- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex information in a manner that others can understand

- A Bachelor's Degree

Competencies:

- Intermediate MS Word and MS Excel skills

- Advanced proficiency with MS Office (Including Outlook, PowerPoint, SharePoint)

- Familiarity with MS Visio and MS Access

- Proven ability to learn new technologies

- Make fact-based decisions

- Support change and innovation

Soft Skills:

o Strong interpersonal skills

o Ability to work independently towards common team goals

o Team player

o Strong communication skills

o Organized

o Ability to manage multiple projects at a time

Competencies

? Integrity Value: Model and Ensure Ethical Behavior

o Comply with Applicable Laws, Regulations and Policies

o Demonstrate Integrity

o Require Integrity and Ethical Behavior from Others

? Compassion Value: Deliver Value to Customers

o Maximize Customer Growth and Retention

o Optimize the Customer Experience

? Relationships Value: Lead and Develop People

o Bring in the Right Talent

o Develop People

o Drive Employee Engagement

o Foster Teamwork and Collaboration

o Learn and Develop Self

o Leverage Diversity and Inclusion

? Relationships Value: Communicate Effectively

o Communicate with Impact

o Influence and Negotiate

o Listen Actively

o Present Effectively

? Innovation Value: Lead Change and Innovation

o Demonstrate Emotional Resilience

o Implement Innovative Solutions

o Manage Change

? Performance Value: Drive Sound, Disciplined Decisions

o Apply Financial Knowledge

o Make Decisions to Drive Action

? Performance Value: Drive High-Quality Execution

o Communicate Clear Direction

o Drive Operational Excellence

o Manage Execution

 
location: Hopkins, Minnesota
job type: Contract
salary: $18 - 21 per hour
work hours: 8 to 5
education: Bachelor's degree
experience: 1 Years
 
responsibilities:
Primary Responsibilities:

Source Management

- Knowledgeable of supplemental data sources - purpose, intent of use, data collection method

- Responsible for audit documentation completion and quality of documentation

- Responsible for medical record requests to support medical record review or primary source verification - related to HEDIS® audit

- Knowledgeable of NCQA HEDIS® technical specifications regarding supplemental data and applicable measures

- Responsible for tracking of source documentation readiness

Data Management

- Maintain documentation of end-to-end data flow of sources

- Knowledgeable of data validation reports of sources

- Awareness of data load to HEDIS® rules engines

Audit Management

- Maintain documentation of audit review outcome by source

- Support Quality Solutions Delivery with HEDIS® audit - for all audit groups involved with annual audit -- address audit issues/concerns within required turnaround time

- Complete work on time, especially as it pertains to HEDIS® audit deadlines

Other Responsibilities:

- Develop & produce ad-hoc reports

- Participate with complex analyses and reports

- Works independently; seeks guidance on only the most complex tasks

- Works collaboratively with other CDSM team members, Quality Solutions Delivery, SDR and PEDS teams

- Support national projects /pilots

 
qualifications:
Qualifications:

- 4+ years of experience with HEDIS® documentation and auditing processes

- 2+ years' experience in Healthcare Industry with clinical data (non-claims), with a focus with understanding of medical terminology and clinical care

- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex information in a manner that others can understand

- A Bachelor's Degree

Competencies:

- Intermediate MS Word and MS Excel skills

- Advanced proficiency with MS Office (Including Outlook, PowerPoint, SharePoint)

- Familiarity with MS Visio and MS Access

- Proven ability to learn new technologies

- Make fact-based decisions

- Support change and innovation

Soft Skills:

o Strong interpersonal skills

o Ability to work independently towards common team goals

o Team player

o Strong communication skills

o Organized

o Ability to manage multiple projects at a time

Competencies

? Integrity Value: Model and Ensure Ethical Behavior

o Comply with Applicable Laws, Regulations and Policies

o Demonstrate Integrity

o Require Integrity and Ethical Behavior from Others

? Compassion Value: Deliver Value to Customers

o Maximize Customer Growth and Retention

o Optimize the Customer Experience

? Relationships Value: Lead and Develop People

o Bring in the Right Talent

o Develop People

o Drive Employee Engagement

o Foster Teamwork and Collaboration

o Learn and Develop Self

o Leverage Diversity and Inclusion

? Relationships Value: Communicate Effectively

o Communicate with Impact

o Influence and Negotiate

o Listen Actively

o Present Effectively

? Innovation Value: Lead Change and Innovation

o Demonstrate Emotional Resilience

o Implement Innovative Solutions

o Manage Change

? Performance Value: Drive Sound, Disciplined Decisions

o Apply Financial Knowledge

o Make Decisions to Drive Action

? Performance Value: Drive High-Quality Execution

o Communicate Clear Direction

o Drive Operational Excellence

o Manage Execution

 
skills: Access, Powerpoint, MS Outlook, Excel, MS Visio, Decision Support, Sharepoint, Audit - Internal
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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