Senior Data Analyst

This position is responsible for QNXT system configuration, contract designation, data maintenance, pricing, fee schedules and provider contracts. Responsible for the analysis and production of multiple projects related to Operational, Clinical, Quality, and Safety improvements for the health plan members, claims operations, health plans and vendors, coordination and troubleshooting of data exchanges such as e-pricing of claims. Uses SQL Server T-SQL to stage data for various processes such as claim editor and auto-adjusting of claims, as well as creating ad-hoc claims, members, provider and benefits reports for CMO-MIS and for Claims Operations teams. Other responsibilities include expertise with CPT, HCPCS, and ICD-9 coding. Employees must utilize analytical and critical thinking skills in order to troubleshoot and solve issues with system maintenance and claims pricing.

Bachelor's Degree Required

Healthcare IT, claims, eligibility, benefits, providers general knowledge and experience.
Trizetto QNXT and Epic experience preferred
Knowledge of Microsoft SQL Server and T-SQL language (database design, ability to create and troubleshoot stored procedures).
Expert level user of Microsoft Excel.
Considerable knowledge of CMO general office practices and procedures
Considerable knowledge of general operating principles and capabilities of computers and various software programs.
Considerable skill and experience in using inductive and deductive reasoning.
Ability to work in conjunction with various clinical, administrative and financial management groups to meet various static, dynamic and interactive data reporting and analysis needs.
Ability to troubleshoot healthcare business issues using QNXT front end and back end access to SQL Server databases.
Ability to support business groups by providing ad-hoc reports to highlight problem areas, such as aging pending claims, missing e-pricing from health plans or various issues.
Skill in preparing documentation.
Ability to provide guidance and training to less experienced staff.
Ability to read, analyze and interpret documents and technical procedures.
Ability to communicate effectively with staff and through business correspondence.
Ability to effectively present information and respond to questions from managers in departmental meetings.
Ability to interpret a variety of instructions given in written, oral, or schedule form
Ability to solve practical problems when related to claims, pricing, benefits or the task at hand.
Ability to think logically in solving problems assigned

Department: CMO Bargaining Unit: Non Union Campus: YONKERS Employment Status: Regular Full-Time Address: 100 Corporate Blvd, Yonkers
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 200896

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Diversity, equity and inclusion are core values of Montefiore. We are committed to recruiting and creating an environment in which associates feel empowered to thrive and be their authentic selves through our inclusive culture. We welcome your interest and invite you to join us.

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law.

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Mission:
To heal, to teach, to discover and to advance the health of the communities we serve.

Vision:
To be a premier academic medical center that transforms health and enriches lives.

Values
Define our philosophy of care, they shape our actions and motivate and inspire us to pursue excellence and achieve the goals we have set forth for the future. Our values include:

• Humanity
• Innovation
• Teamwork
• Diversity
• Equity

Nearest Major Market: Yonkers
Nearest Secondary Market: New York City