CASY-MSCCN Jobs

Facility: Health Plan

City San Diego

Department

Job Status

Regular

Shift

Day

FTE

1

Shift Start Time

Shift End Time

Bachelor's Degree; Master's Degree

Hours :

Shift Start Time:

8:30 AM

Shift End Time:

5 PM

AWS Hours Requirement:

8/40 - 8 Hour Shift

Additional Shift Information:

Weekend Requirements:

No Weekends

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$39.435 - $50.884 - $62.333

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position.  The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do

Provides the Health Services Division with database development and technical support, reporting and analysis that enables data-driven Health Services decision making. Maintains the integrity of extensive spreadsheets, links data from different sources and databases to include functionality of formulas, queries, importing and exporting of data to other programs, and monitors internal and external data needs on an ongoing basis.

Required Qualifications

• Bachelor's Degree in Health Administration, Business Administration, Health Information Technology, or equivalent work experience.

• Previous experience in a managed care setting.

• Experience in medical management systems (e.g., IDX), operating systems (e.g., Microsoft Windows), and a variety of PC-based software programs (e.g., Access, Excel, Word, SQL, and Monarch).

• Experience in development and maintenance of spreadsheets and databases.

Preferred Qualifications

• Master's Degree In health, business, computers, or equivalent work experience.

• General hospital, medical group or other clinical experience.

Essential Functions

• Data integrityIntegrates a process improvement perspective for streamlining data abstraction methods for increased efficiency and improved utilization of available technologies.Provides continual assessment of Health Services data entry, processing, and reporting capabilities, makes recommendations for improvements.Provides analysis of reports prepared internally to identify key trends to ensure data integrity and assess Health Services reporting capabilities.Identifies barriers in data abstraction methods to aid in determining missing data problems.Provides oral or written presentation or verbal communication of analysis.

• Database and record managementUtilizes various PC-based software programs (e.g., Tableau, Smartsheet, Excel, Access, SPSS and Word), operating systems (e.g., Microsoft Windows NT), as well as Monarch and IDX, (Sharp HealthCare's main frame computer system) to develop and maintain a variety of complex databases and spreadsheets for Health Services reporting needs.Designs, builds, and maintains complex databases and spreadsheets to include relative information.Ensures adequate storage and retrieval processes.Compiles core data sets and develops appropriate queries with appropriate documentation.Assists in special projects and development of new departmental and Health Services data management systems.

• DocumentationEnsures that all documentation files will be maintained in a well-organized manner to enable ease in access and data review.Demonstrate organizational ability and initiative in establishing filing system.

• Internal and external customer serviceProvides prompt, accurate and excellent services to internal and external customers.Develops solid professional working relationships with various internal departments and units and, as required, vendors, providers, employers, brokers and/or other customers.

• Other dutiesParticipates in special projects and other duties as assigned. These may include, but are not limited to, work groups, proposals, audits and back-up support for other departments.

• ReportingExtracts, enters, edits, and compiles data from a variety of internal and external sources in order to prepare complex reports and graphs for supporting Health Services management in decision making. Will require summarization of reports from various canned system reports. Imports and exports aggregate and detail data into numerous formats.Data support for provider specific and/or member specific improvement and accreditation initiatives.Provides data analysis support with research, compilation, and review of data to ensure integrity and identify trends in performance measures.Provides support and assistance in the development of databases and registries for performance and/or quality measures.Tests and validates data sets for data accuracy. Prepares ad hoc reports, as assigned, to meet the reporting needs of the department.

Knowledge, Skills, and Abilities

• Working knowledge of hospital, physician and health care operations.

• Demonstrates knowledge of on-line data entry and the ability to organize workflows to maximize efficiency.

• Ability to deal with the IDX main frame database, personal computer database (Access), spreadsheets (Excel), statistical programs and extraction of data through Monarch in a windows environment.

• Ability to effectively participate in various activities and to interact with other departments and staff effectively.

• Demonstrate organizational, analytical and problem solving skills; ability to meet rapidly changing deadlines.

• Working knowledge of procedure, diagnostic, and revenue coding (e.g., CPT-4, HCPCS, CRVS, RBRVS, RVS, ICD-9, etc.) and medical terminology.

• Detail oriented, able to follow directions quickly and efficiently.

• Excellent written and verbal communication skills.

• Ability to meet frequent deadlines and tight schedules.

• Ability to effectively participate in intra-departmental/division work initiatives.

• Completes assignments accurately, meets frequent and tight timelines, and prioritizes workload effectively.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class