- Identify, document, and assess current departmental IT workflows and processes for improvement and efficiency.
- Partner with IT as Lead Analyst for Provider Data Management and, depending on the role, /FACETS, to define requirements and use cases to support business needs, enhancements and to support new business and IT initiatives to improve automation, provider data quality and more
- Actively perform and sign off on UAT for IT enhancements impacting provider data management and credentialing
- Produce weekly and monthly metrics to track Provider Data Management / FACETS KPIs
- Produce ad hoc and regularly scheduled provider reports and metrics for leadership, business partners, and regulatory compliance, as needed.
- Perform root cause analysis on provider data issues including daily/weekly data error reports that impact both internal and external customers, i.e. discrepancies found in data we send on extracts to other consumers (claims and auth databases; directory extracts; data feeds to the EDW)
- Both participate in and lead cross functional workgroups
- Produce financial reporting for the department to track invoices paid; accruals; actuals and report up to management
- Bachelor's Degree required or Certificate in Data Analytics, Informatics, or comparable field.
- 3 years relevant experience as data, systems or reporting analyst.
- Preferred analytical experience in either IT, HealthCare, or Finance domains.
- Provider Data Management experience a plus
- Strong proficiency with the Microsoft Suite, including Access, Excel, PowerPoint, Visio
- Skilled with writing advanced Excel formulas and functions, graphs, dashboards
- Advanced SQL skills
- Experience using Data Visualization tools like Tableau, Cognos
- Clear written and verbal communication
- Ability to work independently with minimal direction
- Ability to act as lead project manager, ensuring milestones are met by timeline
- Healthcare payor and provider exposure is a plus (Provider systems, credentialing, claims processing, clinical delivery, member, and provider management, etc.)
- English
-
Data Architect
2 days ago
eRichards Consulting Boston, United StatesOur excellent client is looking for a Data Architect for a one year+ HYBRID in Springfield or Boston. This is a W2 contract so you must be able to work on our W2. Must be local to the MA area. · Duties: The Opportunity · Our client is looking for a highly motivated and experience ...
-
Site/Civil Project Manager
6 days ago
LVI Associates Boston, United StatesOur Client is looking for a motivated Site/Civil for any of their Upstate NY offices - Buffalo, Rochester, Binghamton, Albany and Poughkeepsie · What You Bring to the Table: · A Bachelor's degree in Civil Engineering or related field · Preferred Professional Engineering (PE) lic ...
-
Heating And Air Conditioning Engineer
2 days ago
Rise Technical Boston, United StatesHVAC Engineer · $40 - $55 per hour + Company Vehicle and Fuel Card + Premium Overtime pay (10-12hrs per week) + portal to portal travel pay + Specialist Training · Westborough, MA (Local Patch) · Are you a HVAC Engineer looking to join a market leading Multi-Faceted business maki ...
-
Senior Partner
5 hours ago
Tandem Search Boston, United StatesA leading global consulting firm is looking for a Senior Partner to be a part of their Natural Resources & Energy practice in the US (Boston, New York, Chicago and Washington D.C). Their two main services – litigation and management consulting – are delivered by practice groups t ...
-
Loan Operations Analyst
2 days ago
Selby Jennings Boston, United StatesJoin the Elite Team of Loan Operations Analysts at a Private Investment Firm in Boston · Our client, a prestigious private investment firm located in Boston MA is seeking to add new talent to their team. As a Loan Operations Analyst, you will be responsible for managing various a ...
-
Corporate Associate
2 days ago
Interlink Talent Solutions Boston, United StatesWe are working with an Am Law 100 law firm who are currently seeking a talented Associate to join their growing team based in Boston. · The ideal candidate should have 4+ years of transactional experience and quickly integrate/support the Venture Capital & Emerging Companies prac ...
-
Principal Service Designer
2 days ago
Executive Office of Technology Services and Security Boston, United StatesInterested in solving meaningful problems and transforming the journeys and experiences of millions of constituents interacting with the Commonwealth of Massachusetts government services? We're looking for an experienced, collaborative, and purpose driven Principal Service Design ...
-
Legal Counsel
2 days ago
Larson Maddox Boston, United StatesA Prominent Global Renewable Energy Company that is at the forefront of developing and managing power projects. Known for its commitment to innovation and sustainability, the company offers a diverse range of renewable energy solutions designed to meet the growing demands of the ...
-
Assistant General Manager
2 weeks ago
F1® Arcade USA Boston, United StatesJoin the F1 Arcade Revolution · Immerse yourself in the heart-pounding excitement of F1 racing, the thrill of competition, and the tantalizing aroma of global cuisine—all within the electrifying atmosphere of F1 Arcade. We're not just creating venues; we're shaping destinations w ...
-
Facilities Site Engineer
1 week ago
Trinity Consultants - Advent Engineering Life Science Solutions Boston, United StatesFacilities Site Engineer (Biotech) · Location – Boston · ADVENT Engineering is an engineering and consulting firm providing expertise to the pharmaceutical and biotechnology industries. Head-quartered near San Francisco, California, and with operations in the Eastern and Western ...
-
Senior Project Manager
1 week ago
DBI Projects Boston, United StatesPosition: Senior Project Manager · Position Description: · DBI Projects' Boston office is seeking a hungry, humble, and smart Senior Project Manager to take on key ongoing projects and support our continued growth. Senior Project Managers are responsible for ensuring the ultimate ...
-
Sales/Business Development Professional
3 days ago
USPRO Boston, United StatesSales/Business Development Professional · USPRO is seeking an experienced Sales/Business Development Professional to join its rapidly-growing sales team. In this role, you will be responsible for improving USPRO's client relationships, increasing sales revenue with existing clien ...
-
Technical Architect
4 days ago
Builder Boston, United Statesis looking for an experienced Technical Architect to join our growing Delivery team in Boston on a full time basis in a predominantly office based capacity. · About Builder · We're on a mission to make app building so easy everyone can do it – regardless of their background, tech ...
-
Bridge Inspection Team Leader
1 week ago
Michael Baker International Boston, United StatesThis role is a multi-faceted position involving inspection of bridge and tunnel infrastructure and for those interested, structural design and analysis of bridges. The successful candidate will be able to manage both inspection related duties and sup Team Leader, Inspection, Brid ...
-
Refrigeration Engineer
1 week ago
Rise Technical Recruitment Boston, United StatesJourneyman Refrigeration Engineer · $40 - $55 per hour + Company Vehicle and Fuel Card + Premium Overtime pay (10-12hrs per week) + portal to portal travel pay + Specialist Training · Westborough, MA (Local Patch) · Are you a Journeyman Refrigeration Engineer looking to join a ...
-
Principal Scientist Assay Development
1 week ago
Scientific Search Boston, United StatesPrincipal Scientist, Assay Development · Location: · Woburn, Massachusetts · Are you ready to lead the future of ultrasensitive immunoassays? My client is a trailblazing start-up in Woburn, MA, dedicated to revolutionizing the life sciences, clinical, and academic research ind ...
-
VP of Marketing
1 day ago
Money Fit by DRS Boston, United States: · Human Powered Health, a new human performance company, helps all athletes and health-conscious individuals assess, understand, and apply their unique physiology to maximize their human potential and performance through advanced tools and analytics. · Our team is experiencing ...
-
Loan Operations Analyst
1 day ago
Selby Jennings Boston, United StatesJoin the Elite Team of Loan Operations Analysts at a Private Investment Firm in Boston · Our client, a prestigious private investment firm located in Boston MA is seeking to add new talent to their team. As a Loan Operations Analyst, you will be responsible for managing various ...
-
Managing Director, Allocation
2 weeks ago
D.W. Simpson Boston, United StatesFeeling boxed in by your current job? This role has the opportunity to gain management experience, work with other functions, and interact with key stakeholders. Well established P&C company is in search of a multi-faceted individual to lead a team that provides decision-making t ...
-
Project Manager
1 week ago
Boston Society of Architects Boston, United StatesPayette, based in downtown Boston, is a leading architectural design firm specializing in the programming, planning, and design of complex buildings for medical and scientific research, academic teaching, healthcare, and corporate research. · Payette provides a dynamic, collabora ...
Lead FACETS - Boston, United States - Commonwealth Care Alliance
Description
Why This Role is Important to Us:
The CCA Advisor is tasked with working within the Provider Data FACETS team and partnering with our technology partners, claims and other business partners to understand and identify areas in need of process improvements and automation.
The Advisor will assess and recommend improvements to operational process flows within the Provider Data Space including reporting and metrics around provider onboarding and enrollment, provider data quality, provider directories and credentialing.
This person will also partner with the IT analyst/product owner to help define requirements, develop use cases, review data models and mappings; perform user acceptance testing and provide approval on projects which will enhance and modify existing provider data processes and extracts to downstream consumers of the data including claims systems, directories and state and federal agencies.
Additionally, this person will assume responsibilities in producing financial metrics and KPIs and metrics for the managers and director of the provider team.
The Advisor will also be responsible for producing ad hoc and scheduled reports for the department and other business partners or external customers.
This position will report to the Manager of , Provider Data Management and CredentialingThis role is for an independent self-driven contributor who will lead delivery of projects or reports and may work independently or in matrixed cross functional team.
The expectation is this person can lead a workgroup and mentor team members, as needed.Supervision Exercised:
No
What You'll Be Doing:
Working Conditions:
Standard office conditions.
What We're Looking For:
Required Education:
Required Experience:
Desired Experience:
Required Knowledge, Skills & Abilities:
Desired Knowledge, Skills & Abilities:
Required Language(s):
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable).
Commonwealth Care Alliance is an equal opportunity employer.Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
