Claims Data Steward

Remote

Role Summary

The Claims Data Steward is a member of a cross-functional EDG team who partners with business, technical, and regulatory stakeholders to ensure the implementation of industry and business data standards and its documentation is accomplished. The Data Steward leads complex, cross-organizational efforts to ensure data is fit for organizational use - including but not limited to: risk assessment, metadata management, data quality monitoring, issue management, and knowledge management. Candidates should have a strong data management background and understanding of how data may be organized and of relationships maintained between/among data domains across multiple enterprise systems with a strong drive towards improving data quality and governance.

Responsibilities (related to Claims Data Domain)

• Serves as Data Steward dedicated to health care payer Claims data operations & initiatives
• Works collaboratively with other enterprise and business data stewards to align standards and share best practices; represents Claims data domain in enterprise workgroups and data steward communities of practice
• Leads Data Governance initiatives and collaborations with business and IT operational stakeholders to:
  • Document, define, maintain, and manage data standards and assets, e.g., Critical Data Elements (CDEs), business terms, definitions, reference data, and business rules
  • Ensure the implementation of the data governance program, tools, best practices and compliance with data standards
• Assesses and monitors data quality metrics, analyzes trends, and proactively promotes remediation and preventive action efforts
• In conjunction with the business owners:
  • Defines and communicates metrics to gauge the health and quality of data across enterprise systems
  • Identifies and presents recommendations on business process improvements and efficiencies, including business case and implementation options
  • Provides consultative stewardship services to delivery and issue resolution teams, as needed, to ensure efficient and accurate flow of data.

Skills:

• 5 years professional work experience in:
• Data Governance, Data Management and Data Quality practices
• Healthcare payer data products and processes
• Claims data standards and operations, including:
• In depth subject matter knowledge of health care claim / encounter terminology, concepts and business processes within one or more data subdomains, e.g., medical, behavioral, vision, dental, pharmacy, etc.
• Health care data claim / encounter transactions systems, e.g., Proclaim, Facets, EDI Gateway 837, HL7, FHIR, Arcadia or other claim / electronic medical record (EMR) data sources and data repositories
• Claim / encounter end-to-end lifecycle processes, e.g., submission, processing, payment, reconciliation, etc.
• Claim / encounter reference data standards, groupers and classifications, e.g., ICD-10, CPT, HCPCS, DRG, APC, ASC, SNOMED CT, EDI implementation guides, etc.
• Strong communications skills (verbal, listening, written, and presentation) with management teams and peer groups
• Strong leadership skills to motivate others to achieve goals and inspire change; ability to engage business and data stakeholders to resolve questions or issues; demonstrate ability to create professional relationships and effectively influence cross-functional teams
• Must have the ability to handle multiple and sometimes competing priorities in a fast-paced environment; ability to organize and develop project plans supporting near and long-range goals and actions; able to strategize across complex, cross-functional projects and initiatives
• Must have strong analytical and problem-solving capabilities
• Must be able to think creatively, innovate and flex where needed - quick/adaptive learner and collaborator/team player
• Self-motivated and able to function with minimal direction
• Intermediate to Advanced skills in data analysis and data governance tools (e.g., SQL, SAS, TOAD, Python, Hadoop, Teradata, Snowflake, Tableau, Collibra, Infosphere, Alation, etc.)
• Project management and Six Sigma skills are a plus
• Experience in Agile Methodology and tools (e.g., Jira, Rally, etc.)

Education: Bachelor s degree or higher

For more information please contact Tom Mazzulla at

Since 1995, iTech Solutions Inc., has been providing IT Consulting and Direct Hire Services to the Insurance, Financial, Communications, Manufacturing and Government sectors with local offices in Connecticut, Minnesota, Colorado, Massachusetts, Tennessee, North Carolina, and New Jersey / Pennsylvania area.

Our recruiting strategy is simple, if you want to find qualified IT professionals then use IT professionals to find them. So at iTech Solutions, our personnel are all career IT professionals with a wide range of IT experience. We can honestly say our staff understands the technologies, the complexities of finding and selecting the appropriate personnel and the pressures of running successful IT projects.

Employer will not sponsor applicants for any employment visas, at hiring or in the future, including but not limited to H-1B visas. Corp-to-Corp or subcontract personnel will not be considered for this position.