Associate Director of Managed Care Informatics & Data Management

Overview

Associate Director of Managed Care Informatics and Data Management

Job Locations US-CA-Los Angeles

Category Managed Care

Type Regular Full-Time

Our premier client is seeking a full-time, Associate Director of Managed Care Informatics and Data Management to assist our Managed Care Division located in Los Angeles, California

Hours of Operations :

Monday - Friday, 8 : 30am-5 : 30pm

Responsibilities

Summary :

Under the direction of the Chief of Managed Care, the Associate Director of Managed Care Informatics and Data (ADMCID) is responsible for the direction and oversight of analytics, reporting, and research to support operational goals. The ADMCID works collaboratively with IT data management staff to assure that strategy, tactics and execution of data related processes are communicated and understood by MC operations, finance and IT staff. The Associate Director is available to consult with staff in order to assist the IT data management staff and / or finance staff with their required clinical, financial, and other data reporting responsibilities to local, state and federal agencies.

The Associate Director, Managed Care Informatics and Data role contributes to the Foundation's success by developing management and operational reports, performing system support, analysis, and consulting on configuration, conducting data mining, and preparing data for presentation and audits, as well as working on assigned managed care projects necessary to support operational needs, grow the division, and improve the efficiency and quality of care and services delivered. This position is responsible for the management and coordination of focused projects working with Managed Care data and analytics as assigned by the Chief of Managed Care. The Associate Director, Managed Care Informatics and Data supports business strategies through the development of dashboards, reporting, and improved business and technical processes. This position requires significant capacity to manage multiple competing objectives, to prioritize, and to communicate complex information in clear and unambiguous terms to management, cross-functional team members and end user personnel.

The Associate Director, Managed Care Informatics and Data role requires an individual be independent and self-motivated and capable of developing approaches customized to meet the needs of any given request. The Associate Director of Managed Care Informatics and Data must be able to effectively lead data initiatives to improve not only the basic reporting, but also the business and technical processes involved with creating and validating reliable data. The Associate Director will need to be able to address issues by presenting analysis of issues, assessment of the results, development and implementation of long-term solutions, and presentation of fact based recommendations to key stakeholders for critical implementation decisions.

Essential Duties and Responsibilities

• Data and Informatics Responsibilities : Associate Director, Managed Care Informatics and Data oversees and coordinates the extraction, aggregation, and quality assurance of data from multiple sources in support of performing managed care plan and Ryan White reporting, operational reporting and quantitative analyses of utilization, eligibility, quality, and claims data.

Direct the development and execution of analytical and / or research activities to provide senior leadership with information and tools for strategic decision making and planning, health care utilization and costs, opportunities, reimbursement projects and issues, population health and clinical outcomes, provider patterns and variations, trends and forecasting, data and informatics needs, emerging technologies.

Researches applicable subject matter practices and remains abreast of industry trends, pending legislation, and impact of changes in the internal and external environment.

Infuses knowledge of industry trends into the strategic planning process and presents impact to of such trends on new or existing programs to management and staff.

Develops and maintains professional knowledge of health care delivery systems and how they relate to the Organizational enterprise, i.e., Managed Care, Ryan White and other health system contracts, regulations and accreditation requirements :

o HIV / AIDS financing structures, i.e., Medicare, Medicaid and Ryan White Care Act

o Local requirements, e.g., Ryan White Planning Council standards,

o State requirements, e.g., California Title 22 and Knox Keene Act, Florida Statute 641 health plan licensing regulations, expansion state requirements.

o Federal requirements, e.g., Code of Federal Regulations, Title 42, §417, Medicare guidance for MA-PD SNPs

o Accreditation standards, i.e., AAAHC, NCQA

o PPACA Health Reform

Serves as or uses subject matter expert(s) related to data and reporting areas being managed by the Associate Director, Managed Care Informatics and Data.

Develops internal and external presentations as well as monitoring the value and success of current or new programs.

Identifies and develops plans to address program gaps and works with Chief, Directors and Project teams to ensure that operations successfully delivers on the intended results of new and / or existing programs.

Other duties as assigned.

Supervisory Responsibilities

This position manages data systems while collaborating and directing multiple individuals across multiple disciplines during a project.

Organizational Meetings

MC Staff Meetings

IT Data Meetings

Managed Care Operations

MC Director Meeting

Attends Project Management meetings for assigned work efforts

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and / or Experience

Experience working with SAS, SQL, DB2, and other reporting and programming languages

Experience with working with managed care enrollment and claims data

7+years in healthcare analytics / informatics and report development experience

3+ years' experience with analytics in data warehouse environment

5+ years' experience managing analytical teams

Experience with advanced data visualization tools a plus

Computer / Software Skills & Abilities

To perform this job successfully, an individual has should have knowledge of Microsoft Office software in addition to understanding Microsoft SQL and DB2 and SAS programming languages.

Microsoft

Software

Level

Skill

Word

Advanced

This level of skills is necessary in order to use and create a variety of templates, complex tables, merges; manage table data, sort and filter merges, and also perform basic work with existing Macros. A person with this level of skills is able to customize toolbars, import and insert graphs, embed Excel data, and elaborate reports.

The person has the skills to

Excel

Advanced

This level of skills is required to work with multiple worksheets; filter data, use integrate functions, and manipulate databases. With this level of skills, a person understands the concepts of databases and is able to work with charts and to use the list management capabilities of Excel.

The person has the skills to

Access

Advanced

This level of skills is required to design, create, and modify databases, tables, queries, forms, and reports. A person with this level of skills understands the different database concepts and structures and is familiar with data validation and indexing techniques

The person has the skills to

Power Point

Intermediate & Advanced

This level of skills is required to customize templates and the PowerPoint environment, and to make a presentation interactive by using hyperlinks and action buttons.

The person has the skills to

Visio

Intermediate

This level of skill is required to develop process flow charts, organizational charts and incorporating drawings into other documents

The person has the skills to :

Internet Explorer

Intermediate

This level of skill is required to conduct research, obtain data and connect with work related social networking programs.

The person has the skills to :

Language Skills :

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.

Mathematical Skills :

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent to draw and interpret bar graphs.

Reasoning Ability :

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Ability to assess situations and critically evaluate alternative problem solving to effect solutions and forward progress.

Other Skills & Abilities / Qualifications :

Well-qualified professionals please submit current resume / CV, compensation requirements along with geographical preferences in complete confidence to

Division Group Manager

asonus@pailingroup.com

Pailin Group Professional Search Consultants

J-18808-Ljbffr