Informatics Specialist Lead- Novitas
GuideWell Source
Full-time
Remote friendly (Alabama, United States, Arkansas, United States, Florida, United States, Georgia, United States, Idaho, United States, Indiana, United States, Iowa, United States, Kansas, United States, Kentucky, United States, Louisiana, United States, Mississippi, United States, Nebraska, United States, North Carolina, United States, North Dakota, United States, Ohio, United States, Pennsylvania, United States, South Carolina, United States, Tennessee, United States, Texas, United States, Utah, United States, West Virginia, United States, Wisconsin, United States, Wyoming, United States, Alabama, United States, Arkansas, United States, Florida, United States, Georgia, United States, Idaho, United States, Indiana, United States, Iowa, United States, Kansas, United States, Kentucky, United States, Louisiana, United States, Mississippi, United States, Nebraska, United States, North Carolina, United States, North Dakota, United States, Ohio, United States, Pennsylvania, United States, South Carolina, United States, Tennessee, United States, Texas, United States, Utah, United States, West Virginia, United States, Wisconsin, United States, Wyoming, United States)
United States
Informatics, Data Abstraction
Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.
Benefits info:
* Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
* Short- and long-term disability benefits
* 401(k) plan with company match and immediate vesting
* Free telehealth benefits
* Free gym memberships
* Employee Incentive Plan
* Employee Assistance Program
* Rewards and Recognition Programs
* Paid Time Off and Paid Sick Leave
Benefits info:
* Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire
* Short- and long-term disability benefits
* 401(k) plan with company match and immediate vesting
* Free telehealth benefits
* Free gym memberships
* Employee Incentive Plan
* Employee Assistance Program
* Rewards and Recognition Programs
* Paid Time Off and Paid Sick Leave
SUMMARY STATEMENT
Serves as the lead technical expert of the Informatics team, provides guidance to the Informatics Specialists, and assists with leading analytic and reporting projects. Blends technical expertise with strategic insight to improve workflows, support evidence-based decision making, and maintain robust data governance and compliance.
ESSENTIAL RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
Able to perform the duties of a Level 1, 2, and 3 PLUS:
Technical Leadership -- 50%
* Lead the design, testing, and deployment of analytics solutions.
* Mentor, train, and support informatics staff and end users to enhance system adoption and proficiency.
* Perform advanced programming and/or modeling and statistical analysis/support.
* Stay current on emerging technologies and best practices to drive innovative solutions.
Technical Leadership -- 50%
* Lead the design, testing, and deployment of analytics solutions.
* Mentor, train, and support informatics staff and end users to enhance system adoption and proficiency.
* Perform advanced programming and/or modeling and statistical analysis/support.
* Stay current on emerging technologies and best practices to drive innovative solutions.
Operations -- 30%
* Develop and maintain departmental policies, procedures, and best-practice documentation.
* Ensure alignment of data systems with organizational goals, regulatory requirements, and best practices for data governance and analytics.
* Independently lead and/or manage large projects and work groups that support organizational initiatives and strategies.
* Develop and maintain departmental policies, procedures, and best-practice documentation.
* Ensure alignment of data systems with organizational goals, regulatory requirements, and best practices for data governance and analytics.
* Independently lead and/or manage large projects and work groups that support organizational initiatives and strategies.
Reporting & Data Analysis -- 20%
* Monitor system performance metrics and drive continuous improvement initiatives using data analytics tools.
* Provide accurate, immediate, consistent data, reporting and analysis to support business management and initiatives.
* Utilize appropriate software to design visualizations.
* Conduct complex analysis.
* Perform data profiling/analysis activities that helps to establish, modify, and maintain data models.
* Identify trends through data analysis, inform clinical decisions, and drive performance improvements.
* Monitor system performance metrics and drive continuous improvement initiatives using data analytics tools.
* Provide accurate, immediate, consistent data, reporting and analysis to support business management and initiatives.
* Utilize appropriate software to design visualizations.
* Conduct complex analysis.
* Perform data profiling/analysis activities that helps to establish, modify, and maintain data models.
* Identify trends through data analysis, inform clinical decisions, and drive performance improvements.
Performs other duties as the supervisor may, from time to time, deem necessary.
REQUIRED QUALIFICATIONS
* Bachelor's degree in Statistics, Analytics, IT, Engineering, or related technical field
* High School diploma or GED
* 6 years' related work experience
* Proven track record managing complex projects from conception through deployment
* Strong understanding of data governance principles and healthcare regulations
* Fluent in a variety of applicable programming languages, software, and systems (R, SQL, SAS and/or Python).
* Strong data mining skills to thoroughly review and analyze data to discover vital information to effect lower claims error rate and reduce outlier billing patterns
* Demonstrated data analysis skills
* Basic knowledge of statistics
* Basic knowledge of Medicare Part A and B programs
* Proficient in Microsoft products
* Exceptional technical writing skills
* Bachelor's degree in Statistics, Analytics, IT, Engineering, or related technical field
* High School diploma or GED
* 6 years' related work experience
* Proven track record managing complex projects from conception through deployment
* Strong understanding of data governance principles and healthcare regulations
* Fluent in a variety of applicable programming languages, software, and systems (R, SQL, SAS and/or Python).
* Strong data mining skills to thoroughly review and analyze data to discover vital information to effect lower claims error rate and reduce outlier billing patterns
* Demonstrated data analysis skills
* Basic knowledge of statistics
* Basic knowledge of Medicare Part A and B programs
* Proficient in Microsoft products
* Exceptional technical writing skills
PREFERRED QUALIFICATIONS
* Master's degree in related technical field
* 6 years' experience analyzing Medicare claims/provider/beneficiary data
* Good working knowledge of:
o Contract's Medicare claims processing systems
o Medical terminology
o CPT, ICD-9, and HCPCS coding structures
o Experience with relational databases
o Business process design and requirements development
* Project Management Certification
* Python Coding Experience
* Master's degree in related technical field
* 6 years' experience analyzing Medicare claims/provider/beneficiary data
* Good working knowledge of:
o Contract's Medicare claims processing systems
o Medical terminology
o CPT, ICD-9, and HCPCS coding structures
o Experience with relational databases
o Business process design and requirements development
* Project Management Certification
* Python Coding Experience
Qualifications
The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive.
Background Investigation: If you are selected for this position, you must undergo a pre-employment Background Investigation, Drug Screen, and Identity Proofing documentation must be cleared prior to hire. Most positions are subject to additional Identity Proofing, Fingerprinting and additional Background Investigation screening conducted by the Federal Government to be granted Enterprise User Administration (EUA) system logical access after you begin your employment. Your continued employment is contingent upon the outcome of the complete additional screening criteria required for the position which must find that you meet the applicable government customer's requirements (e.g., suitable for access to CMS information and information systems), as well as any additional investigation which may be required throughout your employment. If you are found not suitable, your employment may be subject to corrective action, up to and including immediate termination of employment.
Identity Documentation: You must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents. Note: Employment Authorization Cards (EAD) are not a substitute for Visas or U.S. Permanent Resident Cards.
"We are an Equal Opportunity/Protected Veteran/Disabled Employer."
This opportunity is open to remote work in the following approved states: AL, AR, FL, GA, ID, IN, IO, KS, KY, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require further approval. In FL and PA in-office and hybrid work may also be available.