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Spectrum Health Sr. Healthcare Reimbursement Intelligence Analyst - Remote in Grand Rapids, Michigan

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Job Description

Performs self-driven intelligence analysis through SQL-based report building to support decision making in the healthcare provider reimbursement space. Partners with the business to turn data into critical information and knowledge. Possesses an advanced understanding of healthcare reimbursement data and/or analytics.

Develops reports, projection models, and dashboards in addition to contributing to the improvement of existing processes through automation. Contributes to data-driven decision making in the healthcare industry, possessing knowledge of reimbursement methodologies.

Builds relationships with internal and external users for direct consumption or integration with other systems. This role promotes data literacy by educating and training customers to use the data as an analytical tool, displaying the information for the purpose of analysis and exploration.

Without supervision, designs, codes, configures, tests, debugs, deploys, documents, and maintains programs. Uses a variety of software development tools, programming languages and testing/verification applications. This role creates and adheres to development best practices and quality standards. Gathers business requirements and translates the information into detailed technical specifications from which programs will be written or configured, and to validate that the proposed applications align with both the architectural design and business needs. Works closely with other Business Intelligence Analysts, Intelligence Developers, Data Engineers, Data Scientists, and internal/external customers. Coaches less experienced Business Intelligence Analysts. This role will support the provider incentive plan, overhaul expectations, and deliver data to program leaders.

Essential Functions

  • Provide analytic solutions that turn data into critical information to understanding a systemic business problem using SQL. Familiar with Oracle and Microsoft SQL server environments.

  • Translates and documents business program needs into a technical solution using visuals and creating data sources, metrics and automation. Visuals, data sources and automation will be created from electronic health record (EHR) reporting tools and databases, (ie FACETs, eVIPS, Optum), cloud reporting systems (ie Snowflake), and other EHR agnostic tools (ie SSIS, GoAnywhere, Tableau, PowerBI, etc). Presents that technical solution to key stakeholders

  • Independently able to provide troubleshooting, maintenance, support, oversight and technical guidance

  • Possesses knowledge of workflows in multiple business areas to support data development, analytics and quality improvement activities. Guides less experience Business Intelligence Developers in gaining workflow knowledge

  • Performs job-related duties in conformance with IS standards and initiates and leads team through new/improved standards. Coaches less experienced Business Intelligence Developers.

  • Designs, codes, configures, tests, debugs, deploys, documents, and maintains self-service reporting assets and Extract, Transform and Load (ETL) for the purpose of populating data warehouse assets and sending data outside of data warehouse assets

  • Participates in Agile ceremonies determining the nature and scope of project activities and processes to be developed or modified, working across teams to communicate development dependencies to accomplish final solution

  • Works with data architects as the architect designs relational and dimensional data models to verify that the model meets the use cases and aligns with strategic direction

  • Certified Revenue Cycle Representative and/or Payment & Reimbursement Specialist Preferred

  • SQL-based, data analytics experience in Healthcare Reimbursement, Healthcare Revenue Cycle, Healthcare Finance, or equivalent Preferred

Qualifications

  • Required Bachelor's Degree or equivalent in business, liberal arts, computer science, application programming, software development, information systems, database administration, mathematics, engineering, or other related field

  • 5 years of relevant experience Required

    r emote work for this position may be approved based on policy and business considerations

Primary Location

SITE - Priority Health - 1239 E Beltline - Grand Rapids

Department Name

PH - Provider Analytics

Employment Type

Full time

Shift

Weekly Scheduled Hours

40

Hours of Work

8:00 a.m. - 5:00 p.m.

Days Worked

Monday - Friday

Weekend Frequency

N/A

Spectrum Health requires all team members to receive the COVID-19 vaccinations subject to certain exclusions based on the team member’s job category. Spectrum Health is committed to granting reasonable accommodations in accordance with applicable laws.

Accommodation Notice: If you are a qualified individual with a disability, you may request a reasonable accommodation in Spectrum Health's application process. Contact us at 616-486-SHHR (7447).

Spectrum Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, sexual orientation, veteran status, or any other legally protected

category. See more here (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf) .

Spectrum Health requires all team members to receive the COVID-19 vaccinations subject to certain exclusions based on the team member’s job category. Spectrum Health is committed to granting reasonable accommodations in accordance with applicable laws.

Who We Are

Spectrum Health is a nationally recognized not-for-profit health system, offering a full continuum of health services through our health plan, medical group and hospital group. As an integrated health system, we are able to work together across all facilities, employees and providers to create exceptional, consumer-focused interactions.

Spectrum Health is redefining what it takes to improve the health of our communities and introducing new and innovative ways for consumers to access high-quality, low-cost care so that they can connect with us for a lifetime of health.

We strive to provide one Spectrum Health experience: a consistent, high-quality, seamless health journey for consumers; no matter where, when or how they interact with us. The result is better health outcomes for the thousands of individuals, families and communities we serve.

We are the region’s largest employer, with corporate offices located in Grand Rapids, Michigan. Spectrum Health Hospital Group and Spectrum Health Medical Group are consistently recognized for the exceptional care they provide. Priority Health is among the largest health system-sponsored health plans in the U.S. and offers extensive experience serving large and small employer groups, individuals, Medicare Advantage, Healthy Michigan Plan and Medicaid populations.

Since 2010, Spectrum Health has been listed five times among the 15 Top Health Systems in the U.S. by Truven Analytics™. Click here (https://www.spectrumhealth.org/about-us/quality-safety-and-patient-experience/awards) to see a complete list of our safety, quality and patient experience awards.

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