Medline Industries, LP is the leading nationwide supplier of medical, surgical and pharmaceutical products to hospitals, nursing homes, HME providers, surgery centers, physician offices and home care/hospice settings. Due to continued growth, we are in need of a Senior Workday Reporting Analyst.

Position: Senior Reporting Analyst Location: 100% RemoteJob Type: 6 Months Contract - Possible extension Hiring Manager Notes: <ul><li>Looking for 5+ years of overall reporting exp.</li><li>Client is trying to add some additional prior authorization requirements around imaging</li><li>Working w/ a vendor called Evicore (handling utilization mgmt). Go-Live at end of July...</li><li>Evicore will be dropping the utilization data into snowflake then this person will be using SQL and Informatica to grab the data out of snowflake in order to create the reporting infrastructure.</li><li>First and foremost, this person needs to build out the reporting capability/infrastructure... After that, there may be a need to build dashboards out with PowerBI and Tableau.</li><li>Core tech stack required: Snowflake, Informatica Intelligent Cloud Integration Services and SQL.</li><li>Ideally would like them to have a BG in Utilization mgmt or authorization data (preferred). But must have the healthcare BG.</li><li>Interview process: One interview</li></ul> Job Description--------------------PURPOSE:Drives critical business decisions by analyzing metrics and designing reports. Serves as a task lead to plan and design the analysis and then execute the plan. Oversees the process of enhanced reporting development and acquisition of reporting and analysis tools. Provides input or may prepare complex/intricate reports/presentations based on the interpretation of analyzed data. ESSENTIAL FUNCTIONS:25% Briefs analysis results and recommendations to executives, managers, and subject matter expert. Develops solutions to problems and prepares products according to customer requirements. Performs evaluation of alternatives and assessment of risks and costs.20% Evaluates information gathered from multiple sources, reconciles conflicts, decomposes high-level information into details, and abstracts up from low-level information to a general understanding.20% Documents requirements based on design, cross-functional integration, feasibility studies, and functional process specifications. Assembles, prepares, and analyzes data in respective business area; presents analysis/data to client in support of statement of work. Communicates and collaborates with external and internal customers to analyze information needs and functional requirements.20% Adjusts rapidly to shifts in priorities and manages multiple tasks simultaneously that may include staff support relating to current operations. Applies a depth of knowledge, skills, and abilities to research and conducts process analysis and studies.15% Serve as a mentor or resource for junior level Reporting Analysts. QualificationsTo 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. Reasonableaccommodations may be made to enable individuals with disabilities to perform the essential functions. Education Level: Bachelor's Degree Education Details: Business Administration or related field Experience: 5 years reporting analysis or data management. In Lieu of EducationIn lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. Preferred QualificationsKnowledge, Skills and Abilities (KSAs)Strong research and investigative skills., AdvancedProficient in MS Office programs., AdvancedAbility to maintain effective interpersonal relationships, AdvancedExcellent communication skills both written and verbal., Advanced The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs. Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging. Licenses/CertificationsData Management/Certified Analytics Professional (CAP) Upon Hire Dexian is a leading provider of staffing, IT, and workforce solutions with over 12,000 employees and 70 locations worldwide. As one of the largest IT staffing companies and the 2nd largest minority-owned staffing company in the U.S., Dexian was formed in 2023 through the merger of DISYS and Signature Consultants. Combining the best elements of its core companies, Dexian's platform connects talent, technology, and organizations to produce game-changing results that help everyone achieve their ambitions and goals. Dexian's brands include Dexian DISYS, Dexian Signature Consultants, Dexian Government Solutions, Dexian Talent Development and Dexian IT Solutions. Visit https://dexian.com/ to learn more. Dexian is an Equal Opportunity Employer that recruits and hires qualified candidates without regard to race, religion, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.

General Summary of PositionUtilizes departmental software programs, including Microsoft Word to compose reports from data analysis, Microsoft PowerPoint to present comprehensive visuals, and Microsoft Excel to convert data from text files into an importable format to transfer data to a Microsoft Access database or a Microsoft Excel spreadsheet. Completes reconciliations of Excel spreadsheets to ensure data is accurate. Prepares and submits various daily, weekly, and monthly departmental reports for oversight using Microsoft Excel and other tools as assigned. Utilizes Microsoft Excel and other organization-based reporting tools and applications to abstract, create, provide detail, summarize, and trend data per departmental requests. Supports the MedStar Family Choice Department of Appeals/Grievances/ER Reviews for Maryland Appeals and Grievances, and DC Appeals by building/updating dashboards and reports using Tableau, SQL Server Reporting Services, and other systems interfacing with and required to build reports including advanced data visualizations and interactive features in Tableau. Specifically, position responsibilities include data collection requirements for reports and dashboards, acquiring and managing datasets, developing and publishing reports and dashboards, performing ad hoc analysis, composing report summaries, and delivering data-driven suggestions based on their findings to the Manager of Appeals/Grievances/ER Reviews for oversight. Consults directly with business users, clinicians, analysts, and decision-makers to gather reporting requirements and translate business requirements into functional specifications to implement and update reports and dashboards.Manages Maryland and District of Columbia member/enrollee and provider medical appeals, complaints, and grievances. Responsible for member/enrollee advocate functions. Interacts directly with members/enrollees, staff, physicians, and others on the telephone to resolve issues. Acts as a resource and documents all information as it relates to medical appeals, complaints, and grievances. Assists with the collection of quality improvement information via telephone. Responsible for accurate computer data input, tracking, trending, clerical, survey processing, outbound calls, and correspondence as expected.We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels. Primary Duties and Responsibilities <li>Attends training sessions and workshops offered. Attends and successfully completes required annual mandatory training (SITEL) within the defined time frame.</li><li>Keeps abreast of regulatory and specific changes as it relates to reporting requirements.</li><li>Achieves established monthly goals as related to specific benchmark reporting.</li><li>Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations.</li><li>Maintains established daily performance benchmarks and meets the established productivity standard for the department.</li><li>Meets monthly departmental key performance indicators (KPIs) as they apply to daily, weekly, and monthly reporting deadlines.</li><li>Attends off-site meetings as required.</li><li>Based on the HIPAA Privacy Rule, Security Rule, and Breach Notification Rule, conducts case-related research in the computer system for business purposes only. Correctly categorizes inquiries/complaints and refers cases appropriately to other departments for follow-up; i.e. provider issues, or quality of care issues. Tracks all inquiries or complaints to ensure that cases are resolved within State-required timeframes. Documents resolution and prepares and sends written correspondence in response to members initiating complaints within State / NCQA required timeframes.</li><li>Attends required meetings and participates on committees as directed and expected.</li><li>Coordinates the processing of medical appeals. Evaluates, investigates, and prepares appeals by requesting/obtaining clinical information from providers via fax, mail, and telephone. Must ensure that providers have submitted appeal requests timely. Generates appeal acknowledgment letters and resolution letters per DHMH / District of Columbia regulations. Forwards appeal and related clinical information to the assigned Physician Advisor for determination.</li><li>Demonstrates behavior consistent with MedStar Health's mission, vision, goals, objectives, and member care philosophy.</li><li>Documents all pertinent clinical information in the computer system per policy with accuracy. Works collaboratively with appropriate department staff, and administrative and clinical personnel when appropriate. Completes denial/appeal response form and forwards to administrative staff to generate appeal letter. Ensures that appeal determination correspondence is mailed within DHMH, District of Columbia and NCQA required timeframes.</li><li>Effectively conducts interviews with the members/enrollees, family members, or providers, and collaborates with appropriate department staff and clinical personnel as deemed necessary and assists the member in coordinating care or services when requested or required. Evaluate, investigate, and resolve complaints by obtaining background information and data.</li><li>Process telephone calls from providers, other department staff, and members/enrollees in regard to complaints, compliments, grievance procedures, denials, and appeals.</li><li>Responsible for ensuring all Maryland and District of Columbia clinical information related to medical appeals is scanned and attached to the appropriate event in the computer system.</li><li>Triages all incoming appeal requests via mail, fax, etc. Responsible for forwarding all appeal requests to appropriate team members or departments for timely processing.</li><li>Triages provider inquiries regarding claim denials and payments and redirects to MFC Claims Auditing Dept or MFC Claims TPA to process provider inquiries.</li><li>Works collaboratively with the Claims Auditor to ensure that payments by the MFC TPA are paid correctly based on fee schedules and applied business rules. Shares expertise with superiors and colleagues and provides suggestions for department process improvement efforts.</li><li>Routinely performs self-evaluations and practices self-awareness to maintain and improve work expectations.</li> Minimum Qualifications Education<ul><li>High School Diploma or GEDrequiredand</li><li>Associate's degree Computer science, analytics, or a related field. required</li><li>One year of relevant education may be substituted for one year of required work experience.</li></ul> Experience<ul><li>3-4 years At least 3-4 years of analytics and data visualization experience, with a demonstrated ability to query, clean, blend, validate aggregate, and analyze large datasets to create and update reports and dashboards. requiredand</li><li>3-4 years Customer service experience in a managed care or social service setting requiredand</li><li>3-4 years Medical appeals processing, medical billing claims, auditing, and COB experience. preferredand</li><li>3-4 years Demonstrates ability to create advanced data visualizations in Tableau and SQL is preferred. Experience with relational databases and SQL. preferred</li><li>One year of relevant professional-level work experience may be substituted for one year of required education.</li></ul> Knowledge, Skills, and Abilities<ul><li>Detail oriented, excellent verbal and written communication and organizational skills</li><li>Under general supervision of the Grievance and Appeals Manager performs a variety of complex, responsible and confidential duties requiring a thorough knowledge of organizational procedures and precedents perform routine clerical, administrative duties in support of the Grievance and Appeal Department.</li><li>Attention to detail.</li><li>Excellent time management and organizational skills ability to manage high volume of work assignments effectively </li><li>Strong analytical and research skills.</li><li>Ability to type 40 words per minute.</li><li>Filing skills.</li><li>Knowledge of claims processing and medical billing.</li><li>Knowledge of managed care/healthcare industry preferred.</li><li>Ability to process complex business rules simultaneously to render decisions.</li><li>Logical reasoning and deduction skills for error and problem resolution.</li><li>Excellent interpersonal and customer service skills.</li><li>Strong quantitative analytic skills with an aptitude for analyzing large data sets.</li><li>High proficiency with data management and visualization tools such as SQL and Tableau.</li><li>Solid working knowledge of word processing, spread sheet and database management computer software and applications.</li><li>Passion for analytics with the desire to help drive immediate improvement in business results based on the dataanalysis.</li><li>Proven ability to prioritize work, manage multiple competing priorities, and work in a fast-paced environment with a high volume of time-sensitive information.</li><li>Ability to work effectively independently, work with very little supervision and in a team environment.</li></ul> Why MedStar Health? At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered. We live up to this promise through: <ul><li> Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.</li><li> Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities.We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.</li><li> Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.</li><li> More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.</li></ul> About MedStar Health MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research. Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team. Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities. It's how we treat people. MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees. We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations. MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws. If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.

Reporting Analyst Jobs in Baltimore, MD

Senior Workday Reporting Analyst Remote
June 1, 2024

Senior Workday Reporting Analyst Remote
May 30, 2024

Senior Reporting Analyst
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Senior Reporting Analyst
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Medical Appeals Grievance Reporting Analyst
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Medical Appeals Grievance Reporting Analyst
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Senior Financial Reporting Analyst
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Reporting Analyst Jobs in Baltimore, MD

Senior Workday Reporting Analyst RemoteJune 1, 2024

Senior Workday Reporting Analyst RemoteMay 30, 2024

Senior Reporting AnalystMay 29, 2024

Senior Reporting AnalystMay 26, 2024

Medical Appeals Grievance Reporting AnalystMay 9, 2024

Medical Appeals Grievance Reporting AnalystMay 8, 2024

Senior Financial Reporting AnalystMay 7, 2024