- Conducts data analysis on grievance and appeals data (for both members and providers), service authorization data, and disputes data sets using standard data exploration techniques including trend analysis and outlier identification. Ensures data quality through verification of outlying data points. Communicates logic model, data analysis steps, and results from data analysis to program staff and Bureau leadership to ensure understanding. Conducts analyses and produces reports for quarterly and annual data within two weeks of plan submission of data. Disseminates analyses to Bureau leadership within one month of plan submission of quarterly and annually submitted data.
- Develops and maintains policies and procedures for the management, verification, and maintenance of data associated with the performance of the Bureau of Managed Care and Managed Care contract.
- Conducts data analysis on contract monitoring data sets using standard data exploration techniques including trend analysis and outlier identification. Ensures data quality through verification of outlying data points. Communicates logic model, data analysis steps, and results from data analysis to program staff and Bureau leadership to ensure understanding.
- Leads or supports other projects proactively or as assigned by Office of agency leadership. Continuously engages in process improvement to support Agency, Division, and Office-wide strategies, objectives, and initiatives. Collaborate with other agency team members in research, development, implementation, and evaluation activities for services, projects, and agency initiatives as assigned. Performs other related duties as required.
- Attends and participates in relevant opportunities for professional development and training. Demonstrates utilization and application of new skills learned to improve effectiveness and efficiency within assigned responsibilities.
- Interacting with internal and external organizations (i.e. vendors, State and Federal government agencies, State providers, and other stakeholders).
- Other project-related duties.
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| Required Skills (rank in order of Importance): - Knowledge of methods of research design, data collection, data manipulation, data analysis and presentation of information.
- Knowledge of applicable computer software products such as SAS, Excel, and Python.
- Ability to analyze and interpret data using various statistical and mathematical techniques.
- Ability to predict trends and future action based on the analysis of collected information.
- Ability to prepare and present reports communicating the results of data analysis.
- Ability to maintain effective working relationships with others.
- Ability to communicate effectively.
- Ability to learn new content and skills.
| Preferred Skills (rank in order of Importance): - Experience with federal or state health data systems (e.g., Medicaid, HRSA, HHS, Census) strongly preferred
- Proficient in data analysis tools and techniques, such as SAS, Excel, data visualization tools, and statistical analysis software.
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| Required Education: Master's degree in Data Science, Public Health, Statistics, Health Informatics, or related field. | ADDITIONAL SKILLS: - Superb written and oral communications skills, including the ability to relay moderately complex technical instructions and requests.
- Experience working in a cross- functional team environment.
- Ability to effectively communicate with team members, technical team,
key stakeholders, and vendors. |
