Health Care Data Liaison

Center For Health Information And Analysis • Boston, MA

1d • $62,783 - $120,508 • Hybrid

About The Position

The Center for Health Information and Analysis (CHIA) is seeking a Health Care Data Liaison to monitor the Massachusetts health care system and provide reliable information and analysis to improve health care quality, affordability, access, and outcomes. This role involves performing data compliance review and analysis of data collected from Massachusetts service providers and payers. The position requires close interaction with internal and external parties, including technical staff, data analysts, billing/coding staff, business unit staff, and management. The Liaison will provide front-line support on MA APCD and/or Case Mix Data Sets, submission guidelines, definitions, data mappings, and File Secure/CHIA Submissions usage. A key responsibility is ensuring variance standards are maintained and working to achieve the highest possible data submission percentage. The role demands subject matter expertise in CHIA data specifications, rules, and edits, and the ability to communicate this effectively to carriers and providers. Troubleshooting data issues and identifying resolutions for both technical and non-technical problems are crucial. Collaboration with programmers and other staff on data collection updates and enhancements is also expected. The Health Care Data Liaison will ensure the timely collection of payer and provider data/reports and recommend process improvements for project management efficiency. Under the direction of the Associate Director of Hospital Data Intake and Compliance, the Liaison will draft and edit memoranda, external communications, and analytical reports, and participate in the development of new data collection areas and policy reporting for the agency.

Requirements

• At least (A) two years of full-time, or equivalent part-time professional experience in business administration, health care planning or administration, public health policy or administration, human services policy analysis or administration, economics, the major duties of which included financial analysis of costs, expenses and revenue and/or the development, implementation and monitoring of financial reimbursement systems, or (B) any equivalent combination of the required experience and the substitutions below.
• A Bachelor's or higher degree with a major in health care administration, hospital administration, public health or health services administration, accounting, business administration, business management, public policy, public administration or economics may be substituted for the required experience.
• At least (A) three years of full-time, or equivalent part-time professional experience in business administration, finance, accounting, health care planning or administration, public health policy or administration, human services policy analyses or administration, economics, or a similar field; or (B) any equivalent combination of the required experience and the substitutions below.
• A Bachelor's degree with a major in health care administration, hospital administration, public health or health services administration, finance, accounting, business administration, business management, public policy, public administration, economics, or similar degree may be substituted for a maximum of two years of the required experience.
• A graduate degree with a major in health care administration, hospital administration, public health or health services administration, finance, accounting, business administration, business management, public policy, public administration, economics, or a similar degree may be substituted for a maximum of three years of the required experience.
• At least (A) four years of full-time, or equivalent part-time professional experience in business administration, health care planning or administration, public health policy or administration, human services policy analyses or administration, economics, the major duties of which included financial analysis of costs, expenses and revenue and/or the development, implementation and monitoring of the health care service delivery system and pricing methods
• A Bachelor's degree with a major in health care administration, hospital administration, public health or health services administration, accounting, business administration, business management, public policy, public administration, economics, or similar degree may be substituted for a maximum of two years of the required experience.
• A graduate degree with a major in health care administration, hospital administration, public health or health services administration, accounting, business administration, business management, public policy, public administration, economics, or a similar degree may be substituted for a maximum of three years of the required experience.
• Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.

Nice To Haves

• Experience working with medical claims, membership, and associated data.
• Experience in customer services for medical claims, membership, and associated data collection.
• Experience working with large data files.
• Ability to identify and forecast problems, explore answers, make recommendations, and initiate and execute solutions.
• Demonstrated ability to evaluate data, to draw conclusions and make appropriate recommendations.
• Ability to learn new software applications and techniques related to data submission and compliance.
• Ability to develop rules for required edits and reports to effectively initiate change order requests.
• Ability to translate needs, issues, and ideas into effective action plans.
• Ability to manage workload to simultaneously make good progress on several projects with overlapping deadlines.
• Ability to work independently and effectively with other members of the agency and the carrier/provider community.
• Excellent interpersonal skills: verbal, written, and presentation.
• Excellent documentation skills.

Responsibilities

• Act as Liaison between the MA APCD and/or Case Mix submitters by providing front line support (telephone, email, teleconference and meetings) on MA APCD and/or Case Mix Data Sets and other discharge/claim/cost level data, definitions, data mappings and File Secure/CHIA Submissions usage.
• Work with assigned carriers/providers in the initial set up and development of submitting MA APCD and/or Case Mix test and production data.
• Work with assigned carriers/providers to receive, analyze and provide direction on Variance Requests to obtain the highest percentage of data possible and establish timelines for the carriers/providers to achieve threshold levels.
• Work directly with the data submissions by querying and reviewing files and reports to assist submitters in problem resolution.
• Assist carriers/providers in troubleshooting their submissions.
• Assist carriers/providers in resolving both technical and nontechnical issues pertaining to the submission of MA APCD/Case Mix/Cost data, edits, errors received and data validation.
• Identify issues pertaining to a submission and discuss with carrier/provider, assist with remediation strategy, and timeline for correction.
• Work closely with stakeholders to understand their needs and uses, assist in monitoring whether the data submissions meet those requirements and standards.
• Work closely with other teams to identify and resolve issues.
• Work with assigned analysts, business units, sister agencies in identifying and resolving issues pertaining to a submission, across submissions and across file types.
• Work with analysts, business units, sister agencies to interface with data providers to resolve issues.
• Work with analysts, business units, sister agencies to assist in analysis and watch for defined outcomes.
• Work with data enhancement team and data release team to ensure quality and verification.
• Serve as subject matter expert for data collection, file layout, field contents.
• Assist with and maintain data documentation development and maintenance.
• Assist with workgroup preparation, participation and support.
• Assist reporting groups to understand the data.
• Work with internal and external agency stakeholders to provide liaison support, arrange meetings between submitters and data users and provide outreach on data questions.
• Educate the internal and external stakeholders on MA APCD and/or Case Mix data, submission formats and edits.
• Participate in ad hoc projects related to team and agency-wide initiatives; this may include data analyses and quality assurance.
• Consistently deliver high-quality services to internal and external stakeholders while continually seeking opportunities to increase customer satisfaction and deepen customer relationships.
• Perform submission level QA on the data and assist data analysts in cleaning, validation, standardization, and creative analysis to ensure the best quality of data possible; assist in business unit testing of updates/changes.
• Identify potential processes for automation to assist in data compliance monitoring.

Benefits

• Comprehensive Benefits
• Outstanding suite of employee benefits that add to the overall value of your compensation package.
• Work experience that supports you, your loved ones, and your future.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level