|Job Title:||Data Analyst / Database Analyst / Data Architect|
225 Pictoria Drive, Suite 320
Cincinnati, OH 45246
|Department:||Network Services, HealthSpan|
|The Data Architect designs and builds complex relational databases and data warehouses. The architect works with technical as well as end users to understand business requirements, to create and operate data solutions, database designs, strategies and reports.
It is expected that all of the duties and responsibilities of this position will be performed in a manner that reflects the values of Catholic Health Partners, which are: Excellence, Human Dignity, Justice, Mercy, Sacredness of Life and Service.
Network evaluation and analysis: 50%
• Develops and completes a detailed evaluation and analysis of specialized networks inclusive of hospitals, physicians, midlevel practitioners, ancillary providers by using software tools such as Cactus.
• Evaluate and maintains network configurations for multiple payors including Commercial payors, Medicaid and Medicare.
• Applies state and federal network development requirements.
• Prepares and presents network data to internal and external customers.
• Has a thorough understanding of the Provider networks.
• Oversees and manages special projects as related to networks and network development.
• Manages and follows Provider Relations Administrative policies and procedures and meets key performance indicator requirements.
• Coordinates and interfaces with external vendors.
Provider data base integrity.(50%)
• Responsible for data base integrity.
• Manages provider directory.
• Manages network data for inclusion/exclusion in multiple networks.
• Clearly differentiates networks by developing network tools for various network configurations in provider data base
• Completes and finalizes provider contracting operational processes within the provider data base.
• Maintains a thorough knowledge of provider payment methodology and administration and differentiation within provider data base.
• Adheres and administers current NCQA, CMS, and ODI network standards.
• Establish and maintain excellent customer relations with internal and external customers.
• Promotes HealthSpan.
• Perform/coordinate special or assigned projects as needed.
• Maintains a high level of professionalism and composure in all customer interactions.
• Deals effectively and autonomously with unusual situations involving physicians, office staff and contracted entities.
• Works directly with Providers to ensure network data accuracy.
• Participates in company and individual quality improvement activities as directed.
• Fosters teamwork within HealthSpan by accepting assignments outside of the direct component functions.
• Exercises initiative to identify areas for continuous improvement in the work environment.
|•Bachelor’s Degree required with additional applicable training required.
•Three years’ experience in healthcare environment dealing with network development. Prefer managed care experience of at least three years.
•Analytical abilities preferred.
•Prefer previous network management experience with good motivation required.
•Ability to use good judgment and evaluate situations requiring good decision making.
•Willing and able to learn new information and apply that information to different settings.
•Must have excellent critical thinking skills.
•Demonstrates excellent interpersonal skills.
•Must be self-directed.
•Demonstrates proficiency proficient with Microsoft Office - Excel, Word, Acess. SQL knowledge also preferred
|Apply on-line for this job|
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