Job Description :
Day to Day Responsibilities of this Position and Description of Project:
Provides complex analytical support through the analysis and interpretation of data in support of cross-functional business operations. Develops annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives. Develops, prepares, and analyzes complex reports for management review. Defines complex business requirements and provides analysis toward operational efficiency. Analyzes actual results against plan and forecast and recommends interventions where appropriate. Identifies opportunities for improvement in operational performance and notifies management of issues and problems requiring immediate attention. Works cross-functionally in analyzing, designing and developing business solutions. Provides analytical support for multiple, complex, projects simultaneously, establishes work plans and timelines; coordinates with internal and external sources. Make presentations to various levels of management. Works under limited supervision, using established procedures. Advanced knowledge of automated systems in a production or operations environment. Ability to identify, analyze and resolve complex cross-functional problems related to business operations statistical analysis methodology. Advanced knowledge of and ability to perform analyses such as, GAP analysis, process mapping, root-cause analysis, risk analysis and requirements gathering. Advanced knowledge of PCs and related software applications. Excellent interpersonal and verbal/written communication skills. Excellent writing and presentation skills. Highly developed math, analytical and problem-solving skills and use of analytical tools (e.g. MiniTab, Excel graphs Demonstrated project management skills. B.A/B.S. degree and five years related experience and/or training, or equivalent combination of education and experience.
Responsibilities
Leads a small group to provide analysis, support and guidance to both internal and external customers on moderate to complex electronic data transfers covering enrollment, claims, billing statements and payments
Identifies potential problems and works to define mitigation solutions
Leads efforts to defines user requirements, and user authorization protocols
Leads team in the completion of data transfer testing and reviews submissions for accuracy
Ensures that team efforts align with defined security standards in accordance with industry/company/legal protocols
Monitors team efforts to complete Data transfer scheduling, monitoring and quality assurance activities
Track daily data transfers and production schedules
In conjunction with internal parties, leads outreach programs and activities to external partners (i.e., Employers, brokers, providers including hospitals, medical groups, doctors, IPAs, etc to improve and expand the use of electronic transactions and the seamless transmission of data E2E through BSC systems
Prepares reports and statistics on electronic data transfer usage
· Identifies potential partners/providers for electronic transactions
Able to work with BPO teams to support training and issue resolution for basic data transaction functions
Develops process improvement recommendations to improve successful transfers and reduce file errors

Ability to independently develop and implement moderate to complex electronic data transfer implementations
Skill should include use of query languages and
Able to facilitate groups to resolve issue across multifunctional teams
Understanding of data models, database design development, data mining and segmentation techniques
Strong knowledge of and experience with reporting packages (Business Objects etc), databases (SQL etc)
Knowledge of statistics and experience using statistical packages for analyzing large datasets (Excel, SPSS, SAS etc)
Adept at queries, report writing and presenting findings
· • Knowledge of other file structures and formats such as comma delimited (CSV), XML and fixed-width file formats
Required Skills (Top 3 to 5):
Must have experience
1.
Analytical: Ability to work with large amounts of data: facts, figures, and number crunching along with a capability to see through the data, correlate to business concepts and analyze it to find conclusions.
1.
Nice To Have: Experience / knowledge in Electronic Data Interchange, HIPAA 5010 Transactions (270/271, 276/277, 278, 834, 835, 837)
2.
Communication: Ability to present findings by translating the data into an understandable document. Needs excellent written and verbal skills to easily communicate complex ideas.
2.
Experience & knowledge of SQL – write queries, data concepts, tables
Experience with Excel – Build work books, graph data, charts, reports
3.
Critical Thinking: Ability to look at the numbers, trends, and data and come to new conclusions based on the findings.
3.
Experience & knowledge in data analytics
4.
Attention to Detail: Data is precise and hence the analysts needs to be vigilant in analysis to come to correct conclusions.
4.
Experience & knowledge of healthcare industry
5.
Math Skills: Data analysts need math skills (particularly statistics) to be able to accurately and meaningfully estimate and aggregate numerical data.
5.
Experience working with different data formats – CSV, XML