Specialist, Data Compliance - Indiana
About The Position
The Specialist, Data Compliance – Indiana is responsible for ensuring all Healthy Indiana Plan (HIP) and Hoosier Healthwise (HHW) data conforms to Indiana Family & Social Services Administration (FSSA) and Office of Medicaid Policy & Planning (OMPP) data standards and policies. This role involves managing data quality, change management, and data exchanges with state agencies, ensuring compliance with HIPAA and regulatory requirements, and driving ETL standards. The specialist will work with business areas and IT to ensure data integrity and integration, support data analytics for regulatory compliance, and analyze new regulatory requirements to identify downstream impacts.
Requirements
- Bachelor's degree required
- Equivalent years of relevant work experience may be accepted in lieu of required education
- Three (3) years Managing data quality and data exchange processes including data integration and data verification required
- Healthcare experience required
- Knowledgeable in health care data and health care data exchange standards
- ETL architecture and design
- SQL Server knowledge required
- Communication skills both written and verbal
- Ability to work independently and within a team environment
- Critical listening and thinking skills
- Decision making/problem solving skills
- Training/teaching skills
Nice To Haves
- Experience in data management functions in a multi-faceted environment preferred
- Metadata solutions or tool experience preferred
- Knowledge of managed care preferred
- Knowledge of healthcare data coding such as CPT-4, HCPCS, ICD-9, DRG and Revenue Codes a plus
- Indiana Medicaid knowledge preferred
Responsibilities
- Ensure all Healthy Indiana Plan (HIP) and Hoosier Healthwise (HHW) data conforms to Indiana Family & Social Services Administration (FSSA) and Office of Medicaid Policy & Planning (OMPP) data standards and policies
- Manage data quality, change management and data exchanges with FSSA, OMPP, or its designees
- Responsible for data quality and verification, data delivery, change management processes used for data extract corrections and modification and enforcement of data standards and policies for data exchanges to FSSA & OMPP as defined by the state
- Coordinate with the State and Indiana Market to implement data exchange requirements
- Lead data quality and verification, data delivery, change management processes used for data extract corrections and modifications and enforcement of data standards and policies for data exchanges to the FSSA and OMPP as defined by the state.
- Ensure HIPPA and regulatory compliance rules are addressed for all data movement
- Drive ETL standards and practices toward establishing and following data quality standards as set forth by the FSSA and OMPP
- Work with business areas and IT to ensure integrity and proper integration for all sources of enterprise data
- Prioritize team activities based upon Data Management team priorities and bandwidth
- Work closely with areas directly connected to the Enterprise Data Warehouse to ensure that reporting, business intelligence, and analytic data needs are met
- Assist data analytics of regulatory compliance activities including audit and monitoring results and regulatory complaints and grievances
- Lead analysis of new and changes to regulatory requirements to identify downstream impacts and system, people and process opportunities impacting Indiana market
- Perform any other job related duties as requested.
Benefits
- Bonus tied to company and individual performance
- Substantial and comprehensive total rewards package
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
