The Revenue Integrity Application Developer/Analyst, under the general direction of the AVP of Payor Contracting and Revenue Integrity, functions as the engineer and technical project manager for the Revenue Integrity Department and is responsible for coordinating, developing, and implementing innovative enterprise data-driven solutions, applications, and interfaces. Team member will be tasked in working with a wide variety of systems and technologies in order to recommend areas for improvement to streamline operations and remove human error, system error, repetition, burden, and technical burnout. The Revenue Integrity Developer/Analyst will implement, optimize, monitor, deploy, and develop systems and processes that enable the organization’s staff to improve reimbursement and decrease the costs associated with healthcare back-office business functions. Candidate is responsible for utilizing best practices to guide development related efforts, advise and assist in technical implementations, review technical work completed by internal and external team members, manage multiple operating environments, and assist in implementing, developing, maintaining, enhancing, supporting, and troubleshooting several enterprise solutions. The team member, independently and within cross-functional teams, will provide analysis and projections for unique and new opportunities, detect improvement opportunities in existing operations, develop web and native applications and/or services, and support analysis, improvement, and creation of innovative solutions to complex problems.
EDUCATION, CERTIFICATION, LICENSURE, REGISTRATION:
Bachelor’s or Master’s degree in Engineering, Computer Science, Business Information Systems, Health Informatics, Mathematics, Statistics, Machine Learning / Artificial Intelligence, and/or related technical field (preferred).
EXPERIENCE, SKILLS AND KNOWLEDGE:
2. 2+ years of working knowledge of T-SQL (specifically with one or more of the following platforms: MSSQL, MySQL, PostgreSQL, Oracle, Sybase, DB2, or Similar Relational T-SQL Platform)
3. 1+ year of working experience in analytics, business analysis, or comparable consumer analytics solutions. Experience with Tableau, SAP Crystal Reports, Cognos, QlikView, SiSense, SAP Business Objects, SSAS, etc will fulfill this requirement.
4. Basic Knowledge of fiscal management, accounting, and finance.
5. Expertise in healthcare reimbursement, claims management, healthcare business office systems, etc highly desired.
6. Strong attention to details.
7. Highly Skilled in identifying and resolving problem while independently evaluating systems and workflows.
8. Skilled in exercising strong analytical and problem solving skills
9. Highly Organized with Ability to meet deadlines Independently
10. Ability to communicate effectively regarding technical subjects; able to translate business requirements to technical requirements; able to communicate effectively with other non-technical team members.
11. Ability to establish and maintain effective working relationship with all customers, co-workers, staff, and physicians
12. Ability to communicate effectively orally and in writing to customers, co-workers, staff, and physicians
13. Ability to read, understand, and follow oral and written instructions
14. Ability to communicate clearly and concisely both verbally and written
JOB SPECIFIC DUTIES AND RESPONSIBILITIES:
1. Evaluate and translates complex healthcare requirements and processes into actionable technical business requirements, solutions, mockups, wireframes, and specifications.
2. Independently analyzes how users and systems interact; identifies and implements improvements; continuously monitors and improves processes. Creativity and “out of the box” thinking is highly desired.
3. Function as a subject-matter expert in the areas of: application development, interface development, back-end service development, web development, and scripting utilizing multiple programming languages and concepts.
4. Performs application and interface development in multiple environments and languages.
5. Independently manages multiple concurrent development projects completed by internal and external developers. Project management duties specifically include, but not limited to: gathering end-user requirements, documentation of technical and operational specifications, building and implementing test plans, operational and technical code review, assisting with end-user functionality testing, implementation, upgrading and troubleshooting.
6. Work with and write queries in multiple databases and data sources (TSQL)
7. Identify and Advise on failure points in various developed and managed systems as related to performance, stability, security, and best-practice compliance.
8. Effectively check-in code to code repositories, ensuring team work, retention, and failure recovery
9. ETL structured and unstructured data as required by projects, frameworks, and software tools being utilized.
10. Produce innovative solutions driven by exploratory data analysis from complex and high-dimensional datasets.
11. Identifies and implements best practices to improve performance and efficiency
12. Responsible for documentation of work and projects to preserve enterprise knowledge
13. Assist in working with external vendors and contractors.
14. Conducts financial, statistical and business analysis, business and financial forecasting, and financial spreadsheet modeling, using large data sets and a broad range of tools and technologies.
15. Researches, Develops, Optimizes, and Maintains metrics that monitor enterprise financial and operational performance.
16. Assists in the creation and validation of high level strategic financial decision models and ad-hoc analyses for key organizational strategies and initiatives.
17. Provides analysis and develops models and applications to support system-wide process improvement initiatives.
18. Other Duties as Assigned: Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.