Under the general direction of the Director, Data Management Services, the System Administrator is responsible to manage, coordinate and provide oversight to all day to day Health and Criminal Justice (HCJ) System Administration and Data Analytics processes, ensuring all system administration, data analysis and development, as well as production of related reports are timely and accurate. Provides support to the HCJ Program for System Administration and Data Analytics for all lines of business and functions, Patient Care Coordination, Claims, Finance, Quality and Compliance, Business and Provider Network Development.
Additionally, the System Administrator is responsible for assisting management in ensuring business functions have the system and data resources tools necessary to ensure processes are effective and efficient and allow for accurate data and reporting. Provides information to leadership regarding state-of-the-art data management systems and opportunities to enhance system integration, related databases, and analytical and reporting tools.
Develops and implements information systems analytical tools, standardization and automation of processes, ensuring quality, effectiveness and efficiency of operations, while ensuring compliance with all regulatory and quality requirements as established by state and federal regulations.Responsibilities
- Provides day to day oversight and coordination of all System and Data Administration activities associated with providing comprehensive healthcare services in accordance with the terms of the contracts.
- Oversees the Data Analysts and provides excellent service to internal business partners and external customers; Builds positive relationships with providers and staff.
- Designs and implements a core data system that consolidates data, monitors financial and contract performance, linking specific indicators, and capable of generating reports required by the Federal Bureau of Prisons and other external and internal customers.
- Implements information systems and reporting and analytical tools for achieving contract compliance as it relates to program’s contractual and financial obligations; Ensures compliance with Federal and State regulations, and all other regulatory requirements including but not limited to Medicare, HIPAA, SOC2.
- Ensures design and development of data collection instruments and databases, data warehouse/cubes, data lakes, and systems integrations; Develops analytical and ad hoc reports as needed.
- Designs and implements data management and quality control procedures, including writing technical requirements and documentation of data sets.
- Provides interpretation of data to Senior Management; Provides periodic reports to Senior Management regarding status of assigned projects and recommends corrective actions where necessary.
- Identifies improvement opportunities and resolves client issues to ensure a high level of client satisfaction.
- Collaborates in business expansion planning.
- Designs and implements data management and quality control processes in collaboration with Senior Management .
- Builds continuous monitoring reports, providing insight to Senior Management regarding business operations, identifying and recommending corrective actions where necessary.
- Develops and maintains tracking and monitoring systems to ensure compliance and consistency of established standards and procedures.
- Leverages existing technology by identifying opportunities to automate manual processes and identifies opportunities to incorporate new technology into processes and flows.
- Troubleshoots problems and issues identified by customers and implements corrective actions.
- Regularly analyzes and reports on the productivity and effectiveness of the program in comparison to the established performance metrics; Identifies areas of improvement and recommends resolution.
- Keeps abreast of relevant regulatory requirements, including pending and potential updates; Identifies, and plans for, potential impact to the program.
- Ensures relevant changes to the program and/or contractual requirements can be supported by systems and data.
- Perform other duties as required.
Bachelor’s Degree or equivalent, in Business, Information Systems or related field
REQUIRED WORK EXPERIENCE:
7 - 9 years of related professional experience
Demonstrated ability to build, lead and supervise a team; experience managing a team or functioning as a team lead for a project or group; demonstrated ability to motivate individuals at all levels in the pursuit of common objectives
Demonstrated ability in Data Management and System Administration Processes
Demonstrated understanding and compliance with Medicare, HIPAA, SOC2 and other privacy and security requirements
Working knowledge of industry practice involving key ancillary services associated with the position, including institutional health care, diagnostic services, ambulance services, hospital-based clinical care and managed care contracting and payment methodologies
Demonstrated experience/skills in computer applications, including databases, or other analytical applications; Strong analytic skills and proven competence in independent problem solving
Excellent communication skills; Interpersonal skills necessary to interact successfully with a wide range of stakeholders
Demonstrated ability to meet performance deadlines in a dynamic environment
Demonstrated ability to develop and automate complex reports utilizing analytical and business intelligence tools
Demonstrated ability to analyze data with judgment and discretion and to handle details, multi-task, and prioritize work
Demonstrated proficiency with principles and methodologies of process improvement. Ability to apply these in the execution of responsibilities in support of a process focused approach
Master’s Degree in Business, Information Systems or commensurate experience
PREFERRED WORK EXPERIENCE:
CISA, Certified Information Systems Auditor designation
Previous experience working with HAX or other Medical Office Management System, PeopleSoft, Revenue Capture and or Billing Systems as well as AI and Business Intelligence Systems/Tools
Previous medical billing/accounts payable/claims experience
Previous experience working in healthcare insurance/government contracts and physician office billing practice