Ld Data Quality-Edi Mgmt- Shp- Telecommuting

[H.S. Diploma or Equivalent

Hours

Shift Start Time:

8 AM

Shift End Time:

5 PM

Additional Shift Information:

Weekend Requirements:

As Needed

On-Call Required:

No

Hourly Pay Range (Minimum - Midpoint - Maximum):

$31.495 - $40.639 - $49.783

The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant’s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.

What You Will Do
The Lead Data Quality Specialist – EDI Management performs as a team lead, mentoring and leading data processing activities and recommendations across the EDI Management team. This position will be responsible for researching and resolving complex health plan data issues including eligibility and enrollment, medical claims and other supplemental data files (e.g. pharmacy, premium, etc.). Work in direct collaboration with the Manager of EDI Management and EDI Management staff on recommendations for improved data integration processes and to identify training needs of the EDI Management staff.
Required Qualifications

• H.S. Diploma or Equivalent
• 5 Years Experience in data management or data quality assurance.

Preferred Qualifications

• Some college.
• 10 Years Experience in data management or data quality assurance.

Essential Functions

• Audits
  Researches data discrepancies identified by data audits and reconciliations and accurately updates the data per manual or electronic processing.
  Completes data quality reports and audits within established standards and quality and productivity metrics.
  Works with other departments throughout the Plan to identify needs or existing gaps and puts audit measures in place to close those gaps.
• Data processing
  Provides orientation and training to new and existing Data Quality Specialists. Support training program documentation protocol and ensure new or enhanced processes and clearly documented.
  Meets with decision makers, systems owners, and other users to ensure current processes are still meeting needs throughout the organization.
  Leads meetings with key stakeholders to identify enhancements to business processes and provides recommendations to leadership.
• Data quality
  Ensures data quality and integrity is maintained, data updates and changes, additions/deletions are managed and completed.
  Maintains established quality and integrity accuracy metrics and standards and error rate acceptance levels for manual data entry and edits.
  As assigned, completes reports on department activities, quality assurance audits, and data integrity checking.
  Corrects duplicate and other data errors to maintain data integrity and accuracy standards.
  Assists Systems Analysts in resolving technical issues. Tests and verifies the accuracy of data after system upgrades, changes to screens or processes.
• Human resource management
  Staffing, staff performance plans, evaluates coverage requirements for handling claims. Completes appropriate Human Resources documents according to SHC policies. Prepares and conducts employee performance appraisals in association with Manager. Provides appropriate coaching, counseling, and staff development in association with Manager.
  Employee performance reviews, coaching, and counseling are prepared with sufficient supporting documentation on a timely basis. Conducts monthly individual feedback.
  Timecards and related payroll and Human Resources documents are processed accurately and timely.
  Staffing schedules are prepared that assure adequate coverage. Recommends and implements corrective staffing action to assure that performance standards are met.
  Provides provider training and assistance to staff to maximize knowledge, customer orientation, and quality improvement.
  Demonstrates good judgement and acts within established policies and procedures.
  Fosters an environment that promotes accountability and team work.
• Lead role
  Leads meetings and discussions on Data Quality operations and supports team members in identifying and implementing best practices.
  Provides tier-1 internal support to other data processing team members, resolves issues in-house when possible and makes determination when/if to contact vendors.
  Prepares monthly management reports for data processing activities and turn-around-times.
  Oversees project activities for all new data processing projects or implementations.
  Monitors department documentation and ensures team members are following best practices and policies and procedures.

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class