The client is seeking an Analyst, Systems (Senior) to provide Electronic Data Interchange (EDI) data analysis, reports generation, maintenance and support services for the client Health Benefit Exchange System (HBX).
Duties and Responsibilities:
- Develop, build, and manage complex, operational and federally mandated reports.
- Conduct feasibility studies from design, implementation and post-implementation evaluation from a number of possible approaches.
- Write a variety of queries in SQL and develop reports in SSRS and/or PostgreSQL.
- Identify opportunities for sharing commonly used data internally and externally.
- Interpret data analysis to support decision-making by management and strategic planning.
- Utilize database applications and analytical tools to evaluate data quality, functions and maintain operations.
- Analyze business process to develop data solutions/reports to meet business, application requirement.
- Work in multi-disciplinary teams in a fast paced, technically challenging environment.
- Perform Medicaid 8001 Flat File validation and analysis; review multiple MPIs for SSN matching.
- Perform HBX System Error analysis, validate 1095-A/1095-B files, and reconcile Medicaid 8001 transactions.
- Assist the development team, business operations team and the testing team to analyze, fix, test and transmit EDI files on a daily basis.
- Create data change requests to fix consumer or system reported errors, coordinate with technical and business teams to analyze error reports, access HBX database and application to perform root cause analysis for transaction rejections.
- A minimum of eight (8) years of experience in Information Technology systems analysis.
- A minimum of five (5) years of experience working in a complex IT organization developing a variety of queries and reports utilizing SQL/SSRS.
- A minimum of four (4) years of experience in creating/maintaining EDI X12 files for transactions sets such as 834, 999 and TA1.
- Experience in establishing and maintaining reporting databases and data warehouses.
- Demonstrated ability to manage multiple critical priorities and tight deadlines.
- Demonstrated analytical and problem solving skills.
Bachelor’s Degree from an accredited college or university in Engineering, Computer Science, Information Systems, Business or other related Discipline. Master’s degree preferred.
- A minimum of eight (8) years of the hands-on experience in designing complex queries and reports using SQL.
- A minimum of two (2) years of experience in developing queries and reports in the PostgreSQL database environments.
- Extensive knowledge of data sources, data flow, data/system interactions, and advanced reports design techniques to develop complex analytical reporting solutions.
- Demonstrated ability to develop complex reports utilizing SQL/SSRS.
- Experience with the State Based Marketplace solutions and Healthcare IT or Health and Human Services domains.
- Experience with transactions sets such as 834, 999 and TA1, SOA, EDI and EAI Applications.
- Strong knowledge in the Affordable Care Act (ACA) eligibility rules.
- Knowledge of Medicaid 8001/Interim Database (IDB) file processing.
- Knowledge of Medicaid coverage types, coverage span and eligibility rules.
- In-depth understanding of 834 enrollment transactions including Adds, Terminations, Cancellations and Life events.
- Experience in quality assurance, quality control and compliance processes of large scale Healthcare IT Systems.
- Experience working with the Project Management Office (PMO) processes, policies and procedures.