Reimbursement Systems Analyst III in Boston, MA

Division Of Health Care Finance and PolicyProgrammer/AnalystNumber of Vacancies: 2GENERAL STATEMENT OF DUTIES AND RESPONSIBILITIES: The Programmer/Analyst will be responsible for programming to implement All Payer Claims Database (APCD) data analysis and reporting; developing detail specifications for internal IT application development and service requests related to APCD; developing new approaches to utilize existing APCD structures to answer policy questions; and conducting a variety of programming including database, financial, and quantitative programming and analysis . The Programmer/Analyst will work both independently and in teams to produce accurate, timely and clearly communicated analysis in formats including data tables, graphs, graphic displays and written narratives. DETAILED STATEMENT OF DUTIES AND RESPONSIBLITIES work as needed to program solutions to perform data analysis for the APCD team. programming may involve applications for collection and working with the data, as well as analyzing. programming will be a combination of .NET and Java development. perform programming and data analyses of eligibility and financial data for APCD management reporting and to meet ad hoc programming and analysis requests; perform programming and data analysis work on eligibility status, eligibility changes, trends and shifts, eligibility analyses across MassHealth, the Commonwealth Insurance Connector and the Health Safety Net, health service usage statistics, trends and analyses, and provider payment and cost tracking metrics; Implement Inpatient (AP, APR , CMS) and Outpatient (APG,EAPG groupers from a variety of vendors (3M, IRP, Ingenix) and across platforms (mainframe, #Net). Maintain other software related to grouping/pricing such as Ingenix s Rate Manager Analyze, implement and maintain other medical category classification systems, such as AHRQ s Clinical Classification Software develop new approaches to utilize existing data structures to answer policy questions; define programming and analysis specifications related to data and reporting based on changes to policy, and develop detail specifications for internal IT application development and service requests where neccessary; investigate and resolve data and analysis issues; prepare written memos, reports, tables, and graphs; present analysis orally and in writing, in both formal and informal settings.QUALIFICATIONS REQUIRED AT HIRE (list knowledge, skills, abilities) Fluency in .NET (VB C#), J2EE/JEE, Javascript and Object Oriented programming and data analysis tools including Cognos, Business Objects, ACCESS, SAS, Excel, SQL server and other data query tools. Knowledge of computer applications, data analysis and programming used in the processing of health insurance and financing data. Knowledge of and ability to effectively use the Microsoft suite of office, analysis and presentation tools at an advanced level. Knowledge of and ability to design, construct and effectively use data base structures. Demonstrated proficiency in working with relational databases and stored procedures. Knowledge of and ability to effectively use data integrity and quality assurance techniques to ensure accuracy and completeness of all work products and analytical results. Demonstrated ability to deliver complex solutions in a timely manner. Ability to communicate technical methods to mentor other staff. Knowledge of the methods used in the preparation of charts, graphs, and tables using Excel and other presentation tools. Knowledge of the methods and techniques used in the collection of research data and data manipulation including assembling and correlating information using mathematics and statistical techniques. Knowledge of the methods and techniques of financial, policy and statistical analysis. Ability to analyze and determine the applicability of data, to draw conclusions and make appropriate recommendations. Understanding of programming and analysis task requirements in order to provide accurate effort estimates of own work. Ability to organize tasks and manage time effectively to ensure appropriate prioritization of assigned tasks and efficient use of work time. Ability to maintain accurate records and to track and prioritize own workload, and be accountable to project schedules and timelines. Ability to understand, apply and explain the provisions of the laws, rules, regulations, policies, procedures, specifications, standards and guidelines. Ability to follow oral and written instructions and to give oral and written instructions in a precise, understandable manner. Ability to gather information by examining records and documents and through questioning individuals. Ability to write concisely, to express thoughts clearly and to develop ideas in logical sequence. Ability to communicate effectively in oral expression and to make effective oral presentations Ability to ascertain the approved formats and procedures for preparing and releasing work products. Ability to exercise sound judgment and to exercise discretion in handling confidential information. Ability to deal tactfully and professionally with others, and to establish and maintain harmonious working relationships. Ability to work cooperatively and effectively in groups and with people at different levels of responsibility within the agency and externally. Ability to adjust to changing situations to meet urgency or changing program requirements.. MINIMUM ENTRANCE REQUIREMENTS Applicants must have at least four years of full-time, or equivalent part-time, professional experience in programming in an information technology, or administration, health services research, human services policy analysis or administration or economics environment, the major duties of which included programming and analysis of utilization and financial data such as service use, costs, expenses and revenue and/or the development, implementation and monitoring of financial payment systems.


To apply: http://www.gadball.com/job/20202579/reimbursement-systems-analyst-iii/?sid=18