Unclassified - Richmond, VA

posted 4 months ago

Full-time - Mid Level
Richmond, VA

About the position

The Department of Medical Assistance Services (DMAS) is excited to offer a competitive opportunity to serve as the Senior Systems Analyst for Encounters. The selected candidate will play a crucial role in providing exceptional delivery of services to the agency's Integrated Care Division. This position requires a deep understanding of healthcare encounter processing and the ability to ensure compliance with various standards and regulations. The Senior Systems Analyst will act as the subject matter expert for encounters within the Integrated Care Division, overseeing the creation of data analytics solutions to measure encounter completeness. In this role, the analyst will be responsible for coordinating and monitoring all Commonwealth Coordinated Care Plus (CCC Plus) encounter submissions for Integrated Care contractors. This includes ensuring that all encounter submissions comply with CCC Plus contractual requirements as well as current EDI and HIPAA standards. The analyst will also develop and maintain innovative procedures to assess vendor submission compliance and encounter data quality, ensuring that the agency meets its goals for effective healthcare delivery. The position is based in Richmond, Virginia, a vibrant area known for its proximity to the Blue Ridge Mountains, Virginia Beach, and Washington DC. DMAS is committed to improving the health and well-being of Virginians through access to high-quality healthcare coverage, and the Senior Systems Analyst will be integral to this mission. The agency values service, collaboration, trust, problem-solving, and adaptability, and seeks talented individuals who can align their experience with these core values.

Responsibilities

  • Serve as the Integrated Care Division subject matter expert for encounters.
  • Create data analytics solutions to measure encounter completeness.
  • Oversee, coordinate, and monitor all CCC Plus encounter submissions for IC contractors.
  • Ensure compliance of encounter submissions with CCC Plus contractual requirements and current EDI and HIPAA standards.
  • Develop and maintain procedures to assess vendor submission compliance and encounter data quality.

Requirements

  • Considerable technical and industry knowledge of current healthcare EDI processing standards.
  • Considerable experience and training/certification in SAS or SQL programming language.
  • Considerable knowledge of encounter processing for healthcare encounters.
  • Considerable experience in information technology and project management roles.
  • Considerable knowledge of healthcare claims and encounter technology systems.
  • Considerable knowledge ensuring compliance with necessary federal and state rules, regulations, standards, and laws.
  • Considerable experience in meeting deadlines.
  • Considerable experience with programming tools and reporting methods.
  • Considerable experience working with internal/external stakeholders.

Benefits

  • Health benefits
  • 12 paid holidays
  • Paid leave
  • Flexible work schedules
  • Retirement plans
© 2024 Teal Labs, Inc
Privacy PolicyTerms of Service