Vacancy expired!
- Data manipulation
- Data analysis
- QA Experience
- Communication (oral/written)
- Critical thinking/problem solving
- External client facing role. End to end owner and responsibility for new client data file requests including but not limited to Claims History, Historical Prior Authorization, Disruption analysis and lettering, Continuation of Therapy, etc.
- Leads complex data mapping exercises and data file requirement gathering sessions with external clients and vendors
- Defines methodology and analytic approach as required for end to end vendor transition data file requests including but not limited to Claims History, Historical Prior Authorization, Disruption analysis and lettering, Continuation of Therapy, etc
- Ability to handle a large volume of complex client implementations
- Mentor and lead other team members, providing guidance throughout the implementation process.
- Sought out as an expert.
- Anticipates customers' needs and proactively develops solutions to meet them.
- Performs ad-hoc data analysis, disruption analysis and reporting as required by implementation needs and prepares data for downstream use
- Writes and maintains detailed documentation including specifications, expected outcomes, validation methodology/processes, test results, recommendations, version control, and configuration design related to external data file requirements
- Works with internal stakeholders to ensure data file requirements scheduling, data file intake, client data management, and quality of data based on requirements
- Understands data standards and identifies data abnormalities. Instills data quality in all outputs that are delivered
- Takes personal ownership and accountability for pre-determined Service Level Agreements by following up and following through on all deliverables
- Recommends and implements improvements to existing processes and assists with adoption of new software tools
- Effectively communicates technical and statistical findings with fellow team members and clients
- Possess excellent oral and written communication skills, and is comfortable presenting to everyone from entry-level employees to senior vice presidents, and external clients and coalitions
- Acts as a technical business liaison to explain complicated technical information to non-technical audiences (both internal and external) effectively
- Promptly responds to service failures, resolves issues, and escalates concerns as appropriate
- Provides consistent and thorough updates. Identifies risks and escalates appropriately
- Promotes continuous improvement by ensuring adherence to quality principles and presenting solutions for process excellence. Solves complex problems. Develops innovative approaches.
- Seeks out and actively participates in business initiatives that contribute to service excellence, with minimal leadership guidance
- Keeps current with industries best practices and seeks additional training/seminars to improve technical skills
- May lead functional or segment projects
- Undergraduate degree or equivalent experience
- 2+ years of experience in an external client facing role
- 3 or more years relevant hands-on experience in analytics, business intelligence or comparable data engineering role, including data warehousing, and business intelligence tools, techniques and technology
- Experience with pharmacy claims data, insurance data, managed health care industry and PBM operations
- Ability to write test cases for QA
- Working knowledge of standard business applications, Microsoft Office Suite (MS Access, MS Visio, MS Project, MS Word)
- Advanced proficiency with Excel (Pivot tables, pivot charts, conditional formatting, VLOOKUP, formulas)
- Strong knowledge of PL/SQL (complex joins, nested subqueries, aggregation, partitions, functions, pivots and unions)
- Solid understanding of databases, their architectures and database constraints
- Ability to execute and deliver within the confines and timeframes provided by regulatory agencies
- Strong knowledge of the US healthcare system and healthcare claims data
- Experience with implementation and/or managing pharmacy benefits
- Strong oral and written communication
- Excellent organization skills
- Critical thinking and problem-solving skills
- Adaptable to thriving in a fast-paced environment
Vacancy expired!