Network Management Analyst

MCS Puerto Rico; San Juan (PR); On-site; USD 38,000 - 52,000; Full time

Job summary

MCS Puerto Rico in San Juan, PR seeks a data analyst to collect, evaluate, and maintain critical Census data for daily operations. You will ensure data quality, collaborate with hospitals, and support user testing during implementation of new technologies to enhance efficiency across the unit and organization.

The role requires proactive, analytical individuals with knowledge of PHI handling and adherence to standards and regulations, contributing to strategic initiatives.

Qualifications

• Associate's Degree or 60–64 credits required.
• At least 1 year of experience in Healthcare, preferably in Clinical record-keeping.
• Proven experience may be replaced by previously established requirements.
• Certifications/licenses not required.
• Knowledge of PMHS, True Care, Secure Document Loader, and Provinet; PHI management proficiency.

Responsibilities

• Assess hospitals, rehab, and SNF daily reports to determine Census inclusion per HEDIS TRC & FMC.
• Generate and analyze data to maintain updated Census and reduce prolonged stays.
• Verify and audit Census Reports for data integrity and rectify errors.
• Identify and rectify risk in intrahospital and ER census data; refer to Specialist for action plans.
• Daily audits of SFTP retention, discharge summaries, and CCD uploads.

Skills

Data analysis

PHI handling

Bilingual (Spanish/English)

Education

Associate's degree or 60–64 college credits

Tools

PMHS

True Care

Secure Document Loader

Provinet

Job description

GENERAL DESCRIPTION:

Responsible for collecting, evaluating, and maintaining crucial data for the daily company Census. Accountable for analysis, ensuring data quality, collaborating with hospitals, and supporting user testing processes for implementing new technologies to enhance efficiency in the unit and organization. This role requires a proactive and analytical individual capable of ensuring the company's data integrity, contributing to standards compliance, and participating in strategic initiatives.

Regular

Non-Exempt

GENERAL DESCRIPTION:

Responsible for collecting, evaluating, and maintaining crucial data for the daily company Census. Accountable for analysis, ensuring data quality, collaborating with hospitals, and supporting user testing processes for implementing new technologies to enhance efficiency in the unit and organization. This role requires a proactive and analytical individual capable of ensuring the company's data integrity, contributing to standards compliance, and participating in strategic initiatives.

ESSENTIAL FUNCTIONS:

• Assess all hospitals, rehab, and skilled nursing facilities daily reports and determine the inclusion of cases in the daily Census using specific criteria as required by the HEDIS (Healthcare Effectiveness Data and Information Set) measures TRC (Transitions of Care) & FMC (Follow-Up After Emergency Department Visit for People with High-Risk Multiple Chronic Conditions).
• Generates and analyzes data reported by hospitals, rehab, and skilled nursing facilities to ensure an updated Census and reduce prolonged stays.
• Verify and audit Census Reports to identify necessary updates to ensure data integrity. As well, as rectify erroneous data and ensure information quality.
• Identify and rectify risk situations in intrahospital and emergency room census data. Refer all risk situations to the Specialist to ensure that action plans are taken to prevent further issues.
• Daily audits of the SFTP (Secure File Transfer Protocol) Retention, Discharge_Summary, Assertus_SDL and Assertus CCD (Continuity of Care Document) to ensure discharge summary files are successfully uploaded to the system on time.
• Audit Discharge Summary and CCD images with errors, rectify findings, and ensure successful uploads.
• Analyze, document, and keep facilities and ancillary demographic information up to date. The analyst refers to all identified demographic information that needs to be updated on the system, such as PMHS. This ensures all the provider's information is up to date for internal and external directory purposes.
• Collaborate in coordinating meetings with hospitals to meet HEDIS TRC and FMC standards and requirements.
• Identify patterns in the electronic transmission data to maintain the company Census database integrity. As well, refer all risk situations to the Integration and Interoperability Lead to ensure that action plans are taken in place to prevent any further issues.
• Analyze data reported by the delegated entity FHC (First Healthcare) to ensure an updated Mental Health Census and reduce prolonged stays.
• Collaborate on user testing processes during the implementation of new technologies.
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS:

Education and Experience: Associate's Degree or at least 60-64 college credits. At least one (1) year of experience in the Healthcare Industry, preferably in the Clinical record-keeping and documentation area.

“Proven experience may be replaced by previously established requirements.”

Certifications / Licenses: Not required.

Other: Knowledge of programs such as PMHS, True Care, Secure Document Loader, and Provinet. Proficiency in managing Protected Health Information (PHI).

Languages:

Spanish – Intermediate (comprehensive, writing and verbal)

English – Intermediate (comprehensive, writing and verbal)

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