Data Analyst Sr, Finance - Encounter Data (Covered California)

CalOptima; Orange (CA); Hybrid; USD 84,000 - 135,000; Full time

Job summary

CalOptima is seeking a Data Analyst Sr, Finance - Encounter Data (Covered California) to support the Encounters team within Finance, ensuring accurate data submissions and efficient reporting.

The role requires 5 years of data analysis experience with SQL, 3 years in Medi-Cal/Medicare Advantage, and Covered California experience; the position offers partial telework and collaboration with vendors, providers and stakeholders.

Qualifications

• Bachelor's degree in health care administration, business administration, mathematics or related field plus 5 years of experience as a data analyst creating and maintaining SQL queries and improving reporting methods.
• 3 years of experience in Medi-Cal managed care or Medicare Advantage.
• Covered California (Commercial) experience required.

Responsibilities

• Support the Encounters team within the Finance department; maintain current Encounter tasks.
• Monitor and review 5010 837 file submissions; create and maintain SQL queries to reconcile data for new projects.
• Perform submission testing with vendors for outbound processes with DHCS and CMS; improve data acquisition and reporting methods.
• Ensure timely, complete and accurate data submissions inbound and outbound with the IT team.

Skills

SQL queries

Data reconciliation

Reporting automation

Communication

Education

Bachelor's degree in health care administration

Tools

Microsoft Office

SQL

Job description

Data Analyst Sr, Finance - Encounter Data (Covered California) CalOptima

Join Us in this Amazing Opportunity

The Team You'll Join

We are a mission driven community-based organization that serves member health with excellence and dignity, respecting the value and needs of each person. If you are ready to advance your career while making a difference, review and apply today and help us build healthier communities for all.

More About The Opportunity

We are hoping you will join us as a Data Analyst Sr, Finance - Encounter Data (Covered California) and help shape the future of healthcare where you'll be an integral part of our FIN - Encounters team, helping to strive for excellence while we serve our member health with dignity, respecting the value and needs of each of our members through collaboration with our providers, community partners and local stakeholders. This position has been approved to be Partial Telework.

Your Contributions To The Team

Data responsibilities include supporting the Encounters team within the Finance department, maintenance of current Encounter tasks, monitoring and reviewing 5010 837 file submissions, creating and maintaining SQL queries to reconcile data for new projects, submission testing with vendors for the outbound process with the Department of Health Care Services (DHCS) and the Centers for Medicare & Medicaid Services (CMS), and improving data acquisition and reporting methods. Ensure timely, complete and accurate data submissions inbound and outbound with the IT team. Together, we are building a stronger, more equitable health system.

Do You Have What the Role Requires?

• Bachelor's degree in health care administration, business administration, mathematics or related field PLUS 5 years of experience as a data analyst creating and maintaining SQL queries and improving reporting methods required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• 3 years of experience in Medi-Cal managed care or Medicare Advantage required.
• Covered California (Commercial) experience required.

What the Regulatory Agencies Need You to Possess?

• N/A

Your Knowledge & Abilities To Bring To This Role

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Your Physical Requirements (With Or Without Accommodations)

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Ways We Are Here For You

• Our current hiring range is: Pay Grade: 312 - $84,092 - $134,548 ($40.43 - $64.6865).
• The final salary offered will be based on education, job-related knowledge and experience, skills relevant to the role and internal equity among other factors.

Our Work Environment

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.

Why Join Us?

We believe that diverse perspectives drive innovation. Each employee brings a unique perspective to the overall team and we value everyone's input and we are committed to creating an inclusive environment where you and every team member can thrive while making a meaningful impacts on our community members. Our team reflects and represents the communities we serve, and we welcome candidates from all backgrounds who share our commitment to accessible, quality healthcare.

What's Your Next Step?

All Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. This posting may close at any time without notice after the first review date. If you want to join our team, please apply early to be considered for this recruitment.

Our Commitment to You

Your application and resume will be reviewed by a dedicated recruiter to this position. If your experience matches what we need, we will reach out to you to discuss next steps. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. If selected, a reference and background check will be performed and, if applicable, a drug screening and/or post-offer pre-employment medical examination. If you are an Internal CalOptima Health applicant, apply through the internal portal on InfoNet.

We will keep you updated through each step of the process on your candidate portal. Please check your email, including SPAM, regularly throughout the recruitment process.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health prohibits unlawful discrimination based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics.

CalOptima Health is an equal opportunity employer; individuals with disabilities may request reasonable accommodations at the contact listed in this posting.

To apply, please visit the job posting page for Data Analyst Sr, Finance - Encounter Data (Covered California) on CalOptima's careers site.