Posted in General Business 30+ days ago.
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Location: Miami, Florida
Responsible for management of timely submission of accurate and complete Medical and Pharmacy encounter files to include reconciliation and reporting. Maintain and monitor state reporting for the business unit. Create and manage maintenance of metric documents related to encounter data reporting. Review data to determine operational impacts and needed actions; elevate issues and trends areas for improvement and opportunities to leadership. Develop reports and deliverables by working with multiple systems and analytical tools. Ensure compliance with federal and state deliverable contractual and reporting requirements by performing data quality audits and analysis. Research regulatory and contract requirements. Participate in encounter denial research and work with applicable business units to resolve for resubmission to state.
General Job Information
TitleMgr, Encounter Data Reporting
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date2/9/2018
Date Requisition Created2/8/2018
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
ResponsibilitiesDemonstrated ability to translate business-driven data needs into technical data/programming approach including proper aggregation and normalization of medical and pharmacy data. Ability to effectively communicate complex data/ideas to all levels of management. Experience manipulating large data setsMedicaid knowledgeWorking knowledge of Microsoft Access, SAS, SQL, BI, COGNOS preferred. Excellent quantitative, problem-solving and analytic skills. Strong written and verbal communication skills., Minimum 3 years of experience with the practical uses and applications of healthcare data.
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled