This position is located in Hollywood, Florida.
• Manage all projects, including data collection, data integrity and analysis of all Medicare Enrollment Data. Must be able to work with ambiguous data and multiple data sources.
• Provide technical lead support for Market Prominence including any new development, maintenance or upgrade requests to the system.
• Lead server and system continuity planning, documentation, and implementation; develop policy workflows within the current systems.
• Interface with programmers, analysts, Vendors, Help Desk, Database Administrators, business partners and end users to resolve any support issues that may arise.
• Keep abreast of new developments and trends in areas of responsibility; makes recommendations to manager regarding enhancements, additions or replacements. Train end-users as needed on new software changes.
• Monitor all Enrollment data reports and assist in the implementation of protocols for periodic audits.
• Ensure adequacy of Medicare Enrollment’s response in the event of a disaster or other adverse circumstance.
• Create and maintain database with daily and weekly membership information incoming and outgoing to CMS to accommodate the department in timely retrieval of information upon request for CMS audits.
• Responsible for ensuring all areas within the department are fully compliant and implement methods to track and report trends and provide process improvement suggestions.
• Supports the department in preparing PPM’s , BRD’s policies and procedures and create test records for system upgrades.
• Implement processes to ensure all automated or manual functions are properly monitored and maintained to prevent prolonged non-compliant findings
• Ideal candidate will possess a Bachelor’s Degree in Business Administration, Computer Science, or related field. Additional years of experience may be considered in lieu of degree requirement.
• A minimum of 4-6 years related experience is required, to include 3 years of experience in reporting and technical support in a healthcare administration environment. Additional years of experience may be considered in lieu of reporting and technical support requirement.
• Advanced skills in Crystal Reports, Excel, Microsoft Access and intermediate SQL query building.
• The ideal candidate will possess strong system knowledge to include a thorough understanding of database management and utilizing software such as Oracle, Powerbuilder, and MS Access.
• Familiarity with CMS software applications, CMS reporting procedures, and Litton System is required.
• Knowledge of information systems operations and the ability to articulate business requirements, review data, validate test results, develop procedures and recommend improvements is required.
• Excellent oral and written communication skills are essential
• The proven ability to work independently while managing multiple tasks and deadlines, and knowledge of how to prioritize them is essential.
• Excellent customer service and interpersonal skills and be highly detail oriented, with strong analytical skills and the ability to recognize, diagnose and resolve issues.
• Must be able to work a flexible schedule.
Internal Posting Closing Date: 3/2
EmblemHealth is set on being the mark of good health in the Northeast. The not-for-profit company provides health...