Sr. Data Analyst
Healthways - Addison, TX

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· Own and manage the ongoing data exchange with CMS for MSSP population – this is a monthly and quarterly work effort -
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Monitoring when files are available for processing
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Working with CMS when files do not come in or are corrupted
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Rearranging” eligibility data to include addresses and physician name and getting it into a format HWAYS Data Intake can consume
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Loading medical claims and Rx claims
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Providing eligibility information to the mailing house (or potentially being the mailing house) for MSSP program letters to mail
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Working with Chandler to stop and start the 800 information phone line as a new set of letters are mailed
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Providing CMS with XML attributed lives data for members who are opting in/out of the program to receive next quarters claims data
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Researching data issues or questions from GenHealth or GAPN or clinicians
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Own and manage the ongoing data exchange with ACO groups as they are added – variation of the same duties above but on a weekly and/or monthly basis
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Facilitating the setup for data needs with ACO groups
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Monitoring when files are available for processing
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Working with CMS when files do not come in or are corrupted
· “
Rearranging” eligibility data to include addresses and physician name and getting it into a format HWAYS Data Intake can consume
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Loading medical claims, Rx claims, labs and provider data
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Researching data issues or questions from GenHealth or GAPN or clinicians
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Monitor and troubleshoot THR ADT feed
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Establish standards for data flow between applications – working with HWAYS, GAPN, GenHealth and other groups (such as THR for ADT data or Blue Print)
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Provide operational support for all data exchanges between applications – working with HWAYS, GAPN, GenHealth, ACOs and other groups (such as THR for ADT data or Blue Print)
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Become the SME on how data is integrated and used between all GenHealth solutions and vendors
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Work with physician’s offices to develop standard data extracts from EMRs needed for partnership solutions – this will be an ongoing process as new physician groups join, older ones start using EMRs or change their existing EMRs, etc.
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Assist with technical support for physicians (i.e. Ribbon support, data extracts)
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ADHOC data requests
        Qualifications
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        Bachelor’s Degree required
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        4+ years related experience
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        Previous experience with Healthcare Claims Data, Pharmacy Data, Benefits Data, or related
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        Previous experience/ knowledge of various EMR/ EHRs is highly desired

        About this company
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        For health insurers, healthy plan members are cheap plan members; that's where Healthways comes in. The health services company...