Job Description
Open Until Filled
GENERAL DESCRIPTION
This position is responsible for leading and managing functions related to analysis and information management for the Division of Health Care Financing, requiring considerable judgment and specialized knowledge of the health and utilization management data, eligibility and claims data systems, and multiple Medicaid programs and policies. Upon findings in analysis, make recommendations that lead to new or improved policy and planning decisions, projects, and programs. This position manages high-level projects, studies, and coordinates with staff and other Department of Health Divisions. Projects include collaboration on reporting efforts and projects within the Department and the Business Operations Unit. This position serves as a resource and consultant of Medicaid data, which includes reviewing and validating other programs or vendors' efforts relating to data and data extraction. This position is responsible for leading and managing all functions for all incoming public data, internal, and other requests. Responsible for assigning tasks and managing response timelines through completion. This position is responsible for preparing staff for the division and department HealthStat presentations. The incumbent serves as the central point of contact for the division's participation in HealthStat and functions as the designated HealthStat coordinator for the division, liaising with other positions that have HealthStat-related duties. Schedules and leads all division meetings. Assists all program managers with the completion of necessary forms and serves as the lead for the final submission of HealthStat forms to the Department binder. The Senior Medicaid Analysis and Information Manager must be able to apply judgment concerning communications and confidentiality. This position requires intermediate or advanced-level proficiency in the use of standard desktop applications and Google applications (mail, calendar, sites, docs) used by the State of Wyoming. Working for the State of Wyoming offers more than a paycheck. Our total compensation package includes:
Comprehensive health, dental, and vision insurance Paid vacation, sick leave, FMLA, and holidays Retirement - Pension and 457B plans that help you build a secure future Meaningful work that makes a difference for Wyoming communities and MUCH MORE!
Click here for detailed information , or you can watch this short video to learn about our benefit package! Want to see the full value of your compensation beyond salary? ?? Explore our Total Compensation Calculator:
https://compensationcalculator.wyo.gov Human Resource Contact:
wdhrecruit@wyo.gov ESSENTIAL FUNCTIONS
The listed functions are illustrative only and are not intended to describe every function which may be performed in the job level. Reporting and Analytics Respond to data requests by ascertaining user requirements, collecting, organizing, and analyzing data, and furnishing accurate and comprehensive reports. Analyze, collect, classify, manipulate, store, retrieve, move, and disseminate information pertinent to the Wyoming Medicaid program, Division of Healthcare Financing. Extract and manipulate data utilizing approved Agency business intelligence tools through the development of extensive and intricate queries. Identify salient trends and fluctuations. Execute checks and audits of various data sources to ensure data integrity and completeness. Generate ad-hoc and standard periodic reports to fulfill user needs, employing a variety of business intelligence tools, including Cognos, Tableau, and R. Serve as an internal subject matter expert and consultant on Medicaid health data, encompassing the validation of program initiatives related to data and data extraction methodologies. Develop a thorough understanding of performance metrics, design requisite reports, and conduct analysis to track and evaluate the efficacy of process modifications. Communicate effectively across all organizational levels, verbally to foster teamwork and collaboration, and in written format via reports and summaries. Adhere to assignment timelines and established due dates. Prioritize and manage assigned workload based on user requirements and leadership directives. Undertake other assigned projects as required. Policy and Planning Provides the organization with information for strategic planning purposes regarding enrollment, financial data, utilization, and health outcomes. Contributes to the planning, organization, and development of projects and coordinates efforts with staff and other Department of Health Divisions. This encompasses collaboration on reporting efforts and projects with the units within the Healthcare Financing Division. Functions as the key liaison for the Healthcare Financing Division in the Wyoming Department of Health HealthStat performance management initiative and provides assistance to program managers in presenting data pertaining to their program performance. Serves as the lead Analyst for all incoming public data, internal, and other requests. Responsible for assigning tasks and managing response timelines through completion. This position is responsible for preparing staff for division and department HealthStat presentations. The incumbent serves as the central point of contact for the division's participation in HealthStat and functions as the designated HealthStat coordinator for the division, liaising with other positions that have HealthStat-related duties. Schedules and leads all division meetings. Assists all program managers with the completion of necessary forms and serves as the lead for the final submission of HealthStat forms to the Department binder. Research and Reporting Assumes a pivotal responsibility in the production of specialized, high-level deliverables, encompassing comprehensive projects, in-depth studies, and formalized reports. These critical documents include, but are not limited to, the official Medicaid Annual Report, the detailed Medicaid Per Member Per Month (PMPM) report, strategic data dashboards, and authoritative data whitepapers. Develops research that may inform new or improved policy and planning decisions, projects, and programs. Prepares ad-hoc and topical reports and analyses as required. Special Projects, Research, and HealthStat The position is responsible for undertaking special projects and studies pertaining to healthcare and the provision of services. This includes providing project coordination, support, and assistance across all phases of projects, ranging from simple to moderately complex. The incumbent assists in the design, sampling, and implementation of specialized review programs. This role coordinates internal plan audits to ensure compliance with both state and federal guidelines, analyzes project outcomes and trends, and subsequently provides recommendations regarding related programs. Additionally, the role is responsible for developing reporting requirements and criteria. Program effectiveness in achieving established goals and objectives is determined through assistance with HealthStat and other performance improvement initiatives. The position develops and implements communication tools for new and existing providers, recipients, and external agencies. Furthermore, the incumbent evaluates budgetary impact, tracks and submits review findings, and ensures that all outcomes are accurate and timely. The role involves collaborating with and training other analysts to execute various ad-hoc analyses and reports as requested. The incumbent responds to data requests by ascertaining users' needs, collecting, organizing, and analyzing the necessary data, and furnishing accurate and complete reports. User acceptance testing is performed on vendor-created reports, and assistance is provided to other analysts in validating their reports. The individual is expected to attend training or conferences specific to data management and reporting. Other projects will be assigned as necessary. PREFERENCES
Preference may be given to applicants with a Bachelor's Degree in statistics, information technology, business administration, public administration, healthcare administration, computer science, or a similar field with demonstrated knowledge and experience using related ad-hoc reporting, dashboarding, or statistical tools. Preference will be given to applicants with a Master's Degree and experience/ expertise with data and reporting tools, such as IBM Cognos, Tableau, and R. KNOWLEDGE
Knowledge of accounting, healthcare billing, statistics, and management analysis. Experience demonstrating knowledge of specialized accounting, budgeting, and data analysis. Ability to plan and analyze, conceptualize and communicate data analysis effectively. Understand the complexity of agency programs. Skilled in various data analyses such as data mining, statistical analysis, categorical analysis, exploratory analysis, confirmatory analysis, and predictive analytics. Ability and experience in understanding and using complex database systems and tools, including a Data Warehouse, Cognos, Tableau, R, or other business intelligence tools. Skilled in the Google Suite, Microsoft Office, including Excel, Access, Word, and PowerPoint. Ability to examine and review data and reports for completeness, accuracy, and conformance with regulations. Skills in research and analysis of complex problems; use of complex software systems; analysis of data and identification of problems and solutions; decision-making and evaluation of results. Ability to project trends and expenditures. Working with complex data in undefined activities and constantly changing conditions, situations, and problems requires good judgment in determining work methods to achieve desired results. Ability to quickly identify problems, prioritize needs, research solutions, make decisions, and implement policies and processes in a timely, responsive, and cost-effective manner. Analyze research data, assist in designing projects; establish methodologies for consistent data collection; prioritize projects; recommend project enhancement; research issues using statutes, rules, and regulations; may assist in preparing a procedures manual. Knowledge of Medicaid, Health Information Exchanges, HIPAA, Privacy and Security, Electronic Medical Records, and governance surrounding the same. Knowledge of federal government laws related to state programs using federal funding sources. Knowledge of State and Federal government functions, procedures, concepts, principles, and practices of professional healthcare administration; policies and procedures established for the work system; Medicaid law and regulatory structure. The ability to comprehend federal regulations, state statutes, program rules, and policy. Able to interpret and integrate the foregoing into processes, state and federal laws, policies, and procedures established for the work system. The ability to manage and coordinate complex integration of unique programs, research and analyze issues; identification of options and solutions ability to build consensus among stakeholders. Skills in program management and functional areas; interpersonal relations; team building; goal setting; performance evaluation; and individual motivation. Oral and written communication skills to communicate with a broad audience range, including administrators, legislators, contractors, and staff. Ability to communicate Medicaid program information and policy to public and private entities. Ability to create publications informing stakeholders and the general public of critical program information. Ability to organize and conduct successful and informative meetings and presentations for a diverse audience, including state, federal, and local agencies, legislators, professional associations, medical care providers, and other stakeholders. Skills in public speaking, oral and written communication at a variety of levels and with multiple audiences. MINIMUM QUALIFICATIONS
: Education:
Bachelor's Degree (typically in Human Services) Experience:
1-2 years of progressive work experience (typically in Benefits and Eligibility) with acquired knowledge at the level of a Senior Quality Assurance Specialist OR Education & Experience Substitution:
4-6 years of progressive work experience (typically in Benefits and Eligibility) with acquired knowledge at the level of a Senior Quality Assurance Specialist Certificates, Licenses, Registrations:
None PHYSICAL WORKING CONDITIONS
The employee may sit comfortably to perform the work; however, there may be some walking, standing, bending, carrying light items, driving an automobile, etc. NOTES:
FLSA:
Exempt The Wyoming Department of Health is an E-Verify employer. Click here to view the State of Wyoming Total Compensation Calculator. Click here to view the State of Wyoming Classification and Pay Structure. URL:
http://agency.governmentjobs.com/wyoming/default.cfm The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities. Class Specifications are subject to change, please refer to the A & I HRD
Website to ensure that you have the most recent version.
