Operations Reporting Analyst

Full Time
Philadelphia, PA
Posted
Job description

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

Under the general supervision of the Manager, Service Coordination, the Analyst is responsible for the completion of the Service Coordination components of OLTL OPS Reporting process through the improvement and completion of existing state mandated reporting requirements while maintaining a high level of accuracy, integrity and timeliness of data reports.

  • Develops and maintains a complete understanding of all data sources available for reporting of CHC Service Coordination data.
  • Completes all regulatory reporting requirements assigned, accurately and meeting all regulatory deadlines. Failure to do so may result in the company incurring financial penalties, decreased satisfaction by client (e.g., expansion plans) and compromised relationship with state or other regulatory agencies.
  • Performs data verification through trending, benchmarking or other analyses to ensure data integrity.
  • Maintains electronic and paper documentation supporting the completion of each report for each reporting period within departmental guidelines.
  • Utilizing team approach, works cooperatively with other team members and across departments, including but not limited to Regulatory Reporting
  • Develops and maintains strong knowledge of business practices and the managed care industry in general and applies knowledge to determining data and report solutions.
  • Develops and maintains strong working knowledge of state and other regulatory agency statutory reporting policies and procedures.
  • Uses independent judgment (with supervisory guidance as necessary or appropriate) to ensure reporting is completed as accurately and efficiently as possible.
  • Appropriately identifies and researches any issues or problems potentially compromising the accuracy or integrity of the data reported.
  • Identifies and analyzes Service Coordination data and/or reporting anomalies. Researches and validates SC data results. Provides explanations for variances and changes.
  • Participant in process evaluation and improvement.
  • Communicates with management/stakeholders to determine appropriate courses of action prior to enacting changes in reporting processes.
  • Assist in other tasks or reporting as assigned.

Education/ Experience:

  • Bachelor’s Degree or equivalent experience.
  • 3 to 5 years experience with data, reporting, etc.
  • Basic working knowledge of business computer programs, applications and systems.
  • Basic understanding of business practices.
  • Ability to appropriately extract and manipulate data from a variety of sources.
  • Strong communication (both written and verbal), analytical and problem solving skills.
  • Excellent organizational skills.
  • Ability to identify issues, research, investigates and document findings.

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