Overview
Skills
Job Details
Key Responsibilities:
* Drive critical data analysis through regular oversight and monitoring activities using expense data, customer master, and other fee-for-service data with an eye toward automation.
* Assist HCCOs in providing guidance and oversight on business programs, initiatives, and processes based upon insights and trends identified from monitoring activities.
* Complete special projects as identified, working across HCC and other business functions.
* Prepare and present presentations to HCC Officers highlighting monitoring trends and areas of risk.
* Contribute to Program Management oversight & monitoring efforts by serving as a liaison between HCC Officers, Compliance & Technology Integration (CTI), and Global Assessment and Consulting Services (GACS), reviewing monitoring reports, analyzing for potential issues and trends, conducting, and documenting follow-ups, recommending enhancements, and capturing insights and trends in collaboration with the HCC Officers.
* Identify and/or implement business efficiencies, technology solutions, process improvements and enhanced reporting capabilities to assist in the implementation of a sustainable HCC program.
* Assist in coordinating Risk Assessment process for the region and identifying and driving process improvements across the team. Develop and implement metrics, templates, and/or scorecards to support annual risk assessment and quarterly risk reviews.
* Provide transactional reviews of transfers of value to health care professionals and government officials, perform reviews of material, and engage with business partners to provide guidance on HCC-sensitive topics in alignment with HCC policies/procedures.
* Partner with HCC leadership and HCCOs to create and deliver targeted HCC communications to the HCC community or business partners.
* Assist in developing and/or revising training to support HCC program elements. Collaborate with third-party vendor to communicate training needs.
* Collaborate with HCC Officers to facilitate revisions to HCC policy manual and supporting policy documents as needed
Qualifications
Education:
* A minimum of a Bachelors Degree or equivalent degree
Experience and Skills:
Required:
* Minimum of 1 year business experience
* Excellent English verbal and written communication skills, including formal presentation skills.
* Ability to collaborate in a cross-functional team environment.
* High quality standard with a strong work ethic and professionalism to co-workers and customers.
* Experience identifying and/or implementing process improvement.
* Skill analyzing large data sets.
Preferred:
* At least 1 year in HCC or a compliance related area: monitoring, testing, auditing, finance, compliance, regulatory, law, or a related field
* Ability to work in a complex business environment required
* Demonstrated experience in prioritizing needs and implementing system or process enhancements preferred.
* The ability to break apart large/complex issues into manageable components using analytical skills is necessary.
* Experience working with database and reporting tools preferred.
* Prior experience and/ or training in analytics is preferred.
* Knowledge and experience in the application of web-based reporting tools, website maintenance and/or knowledge of SharePoint is a preferred. Experience in Healthcare Compliance transparency reporting or financial data analysis is preferred
* Experience with data modeling tools
* Self-starter with ability to work independently is preferred