Job Location: Livonia, MI
Employment Type
Full time
Shift
Day Shift
Description
Position Purpose
The Medical Economics (ME) Data Operations Specialist is responsible for providing specialized analytical and technical support for Trinity Health’s Medical Economics department. Defines, designs and implements analytic-driven solutions and services to enable the analysis of data to support strategic initiatives and ongoing business requirements. Develops and manages analytic database and reporting components including utilizing various databases and database management and reporting tools to integrate data from multiple sources into a meaningful data structure aligned with business and clinical metrics and associated concepts, identify issues with source data and design and implement methods to remediate those issues, and utilize the resulting analytic data to derive metrics generate reports, perform advanced data analysis and draft system/process improvement recommendations. Assignments may require interfacing with and gathering information from and making presentations to people in various levels of management and to internal and external executive leaders. Serves as a subject matter expert and resource by providing guidance and problem/issue resolution to internal colleagues on matters impacting projects and day-to-day assignments.
Utilizes advanced analytical and technical skills to perform analysis and to contribute to and oversee design, configuration, implementation, and ongoing management of analytic databases, reports, extracts, models and reporting applications. The Medical Economics Data Operations Specialist plays a significant role in helping to define the business rules for transforming data. Work assignments are complex, requiring familiarity with health care and health insurance data structures and standards, and in-depth knowledge of methods for financial and clinical analysis, including analysis of cost and utilization trends. The position requires strong data manipulation, analytical, investigative, interpretive and evaluative skills along with the ability to contribute to and provide primary accountability for managing/leading large projects or portions of projects is expected.
Essential Functions And Responsibilities
Knows, understands, incorporates, and demonstrates the mission, vision, and values of Trinity Health in behaviors, practices, and decisions.
Expertise level of understanding and working knowledge on the ETL systems using SQL server database (Hands on experience on SQL, T-SQL) and other Microsoft stacks like Visual Studio, SSIS and SSRS.
Good understanding on the source control tools like Github. Prior experience on the performance tuning is helpful.
Develops methods, processes and tools to acquire, integrate, analyze, and export data. Plans processes, systems, policies, regulations and internal controls documents.
Utilizes claim valuation applications, integrated financial systems, relational database management systems, business intelligence and desktop analytical reporting tools to access and manipulate data and develop detailed standard and ad-hoc reports and summaries that support department projects and initiatives.
Translates non-technical requirements into technical business requirements.
Conducts system/data integrity and quality checks/audits and recommends remediation of data issues.
Participates and contributes to the design and development of custom integration as necessary
Conducts analysis, including clarifying the questions to be answered, conceptualizing and implementing the necessary metrics, designing and producing tables, charts and graphs, writing documentation and presentation materials regarding the question, methods, results and recommendations.
Participates in and serves as a subject matter expert in the development of process improvement initiatives that support business needs and enhance the performance of payer claims analysis, product development and the managed care contracting process.
Gathers and exchanges information and provides guidance and problem resolution on complex, challenging and variable situations that demand deep analytical, interpretive and evaluative thinking.
Manages and oversees large projects or portions of projects having a system wide focus, scope of responsibility and impact. Defines and manages project plans and goals; conducts business workflow mapping; impact analyses and modeling; applies action steps, develops status reports or communication plans and keeps management and key stakeholders apprised ensuring project plans and deliverables are met and in alignment with organization goals.
Plays a prominent role in the development and maintenance of standard Medical Economics databases, data definitions, reporting tools, policies and procedures.
Anticipates customer needs and proactively develops solutions to meet them.
Facilitates committee meetings with executive leaders, key stakeholders and decision makers by gathering/exchanging information, coordinating communications and making presentations.
Responsible for researching and compiling detailed information from multiple sources and preparing materials which may include the development of new policies, processes and opportunities.
Mentors, leads and helps train analysts, developers and power users. Manages and oversees team members’ work. Provides and monitors assignments of project team members,
Works with end users on specific questions regarding appropriate use of the Medical Economics and Claims Analytic tools and data.
Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.
Performs other duties as assigned.
Minimum Qualifications
Bachelor’s degree in a quantitative and/or technical discipline, such as Computer Science, Healthcare Business Informatics, Math, Statistics, Engineering, Economics or related field or an equivalent combination of education and related experience. Master’s or Doctoral degree preferred.
Minimum of seven (7) years of experience in the development and usage of analytic data including five (5) years of experience working with large scale data and advanced methods for integrating data from multiple sources and deriving data for business or clinical concepts and metrics.
Minimum of five (5) years of experience writing and tuning advanced SQL.
Knowledge of database management and data analysis tools and applications. Examples include: SAS, SPSS, SQL Server, Oracle, Teradata, Netezza, DB2, Cognos, MicroStrategy, ClikView, Tableau, Spotfire and Business Objects.
Knowledge of medical terminology and coding methodologies Including HCPC, CPT, RBRVS, Diagnosis (ICD-9/10), DRG’s preferred.
Knowledge and experience gained from health plan, health system, the healthcare industry or a provider health network is preferred.
Ability to manage/lead large projects or portions of projects. Ability to work independently and with minimal supervision. Ability to work in a team environment providing support to multiple positions. Ability to solve problems and complete assignments accurately and promptly. Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems.
Ability to drive change and to plan, formulate and implement strategies. Ability to identify, evaluate and demonstrate operational opportunities, business needs, provide authoritative consultation and recognize the interests of executive leaders stakeholders and decision makers.
Excellent organization, analytical, interpersonal, written and verbal communication skills. Ability to facilitate communications between diverse groups.
Strong attention to detail and organizational skills. Demonstrated ability to manage multiple, concurrently running projects and adapt to changing deadlines, competing priorities and unexpected assignments.
Must be comfortable operating in a collaborative, shared leadership environment.
A personal presence which is characterized by a sense of honesty, integrity and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals and values of Trinity Health.
Physical And Mental Requirements And Working Conditions
Must be able to set and organize own work priorities, and adapt to them as they change frequently. Must be able to travel to the various Trinity Health sites as needed (up to 10%).
Must possess the ability to comply with Trinity Health policies and procedures.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.
Our Commitment to Diversity and Inclusion
Trinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.
Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.
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