Virginia Premier Health Plan, Inc.

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Program Integrity Data Analyst II

Program Integrity Data Analyst II

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4040

Job Description

Overview

This position is responsible for coordinating and supporting the analytical and technical aspects of Program Integrity.  The Program Integrity Data Analyst II will create reports and perform data analysis for various audits and projects within Program Integrity

Responsibilities

  • Develop reports related to multiple product lines and business units
  • Oversee technical and data elements of Program Integrity reports
  • Perform intermediate to advanced SQL queries
  • Create automated reporting mechanisms when appropriate
  • Coordinates analytical efforts for special projects and initiatives across Program Integrity
  • Acts as Data Warehouse and SharePoint subject matter expert for Program Integrity
  • Troubleshoots Special Investigative Unit databases
  • Assist in the analytical research and presentation of business opportunities
  • Provides guidance to Special Investigative Unit team related to investigation data elements
  • Support Special Investigative Unit with investigative tasks as needed
  • Provide analytical support to Internal Audit and Compliance teams as needed
  • Other duties as assigned

Qualifications

MINIMUM EDUCATION REQUIREMENTS:

 

  • Bachelors Degree in Business, Health Administration, Finance, Information Systems, or related field. 

SPECIAL KNOWLEDGE AND/OR SKILLS:

  • Proven ability to analyze, visualize, and present data
  • Knowledge of a structured query language, such as Microsoft Access, TSQL, PL/SQL, SPSS or SAS
  • Moderate analytical thinking with some demonstrated talent for identifying, scrutinizing, improving, and streamlining complex work processes
  • Working knowledge of databases
  • Creates complex queries that join multiple tables / sources and significant data massaging
  • Knowledge of healthcare compliance and fraud, waste, and abuse schemes
  • Ability to communicate effectively, both written and verbal, with technical, clinical and business owners, at the Plan and Corporate Office levels
  • Ability to actively contribute in team based environments

 

WORK BACKGROUND/EXPERIENCE: 

  • Required: Minimum 2-3 years of experience in data analysis and/or report development.
  • Preferred: Minimum 2-3 years of experience in Medicaid/Managed Care auditing and investigation
  • Preferred: Six Sigma Green Belt Certification

 

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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