Manager, Data Analytics & Monitoring

Government of Alberta•Edmonton, AB

9d•CA$102,329 - CA$137,705•Onsite

About The Position

The Audit and Compliance Assurance Unit (ACAU) operates within the broad yet specialized environment of the public provincial health system. This health system runs on multi-billion dollar budgets directed towards serving millions of Albertans through thousands of health service providers working in hundreds of health care sites/facilities. ACAU plays an essential role in ensuring those funds are used appropriately to provide insured health services in accordance with the Alberta Health Care Insurance Act (AHCIA). Reporting to the Director of the Audit and Compliance Assurance Unit (ACAU), the Manager, Data Analytics and Monitoring, promotes and develops robust data analytic and statistical methodologies used to identify high risk areas in the health system, and inform the selection of future projects, audits and compliance reviews. The resulting work ultimately leads to cost recoveries and savings, compliance with legislation, and provides the assurance that selected aspects of the health system, such as physician fee-for-service and alternate payment arrangements programs are working as intended. The Manager, Data Analytics and Monitoring, is responsible for providing data analytics expertise and services that contribute to success of the branch's audit and monitoring functions; ensuring that the appropriate issues and concerns are addressed in the execution of audits and reviews; and informing the development of priority initiatives for the annual audit planning process. The Manager combines creativity with logical analysis to look for non-obvious patterns and correlations that may indicate non-compliance. Working collaboratively across the ACAU with audit, clinical advisors and business procedure teams, this role is critical in leading a dynamic data analytics strategy and managing a team of highly specialized data analysts.

Requirements

University graduation in a related field (STEM, Business, or Finance Preferred, others considered with demonstrated, relevant experience), supplemented by four years of related experience.
Demonstrated leadership experience.
Knowledge of the Alberta Health Care Insurance Plan, healthcare billing and physician claims.
Ability to apply knowledge of data analysis and statistics in a range of contexts.
Experience with R, SAS, or other analytic tools.

Nice To Haves

Knowledge of PPHS data (claim and non-claim data) an asset.
Understanding of the principles of Fraud Waste and Abuse.
Strong time management and organizational skills.
Ability to make sound decisions in a timely manner in line with existing policies and legislation and in consideration of relevant information.
Working knowledge of applicable legislation including: Alberta Health Care Insurance Act and Regulations, Schedule of Medical Benefits, Claims for Benefits Regulations, and the Health Information Act.
Strong planning, analytical thinking, and problem solving skills scalable to immediate detailed scenarios and/or longer term broader issues.
Self-directed and initiates ideas and work deliverables in anticipation of new business requirements.
Demonstrated abilities in knowledge management, team building, mentoring, and facilitation.

Responsibilities

Promotes and develops robust data analytic and statistical methodologies used to identify high risk areas in the health system.
Informs the selection of future projects, audits and compliance reviews.
Provides data analytics expertise and services that contribute to the success of the branch's audit and monitoring functions.
Ensures that the appropriate issues and concerns are addressed in the execution of audits and reviews.
Informs the development of priority initiatives for the annual audit planning process.
Combines creativity with logical analysis to look for non-obvious patterns and correlations that may indicate non-compliance.
Leads a dynamic data analytics strategy.
Manages a team of highly specialized data analysts.