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Urgent Requirement for Data Governance (Healthcare Payer Claims) at Remote at Remote, Remote, USA
Email: [email protected]
From:

Avinash Kumar,

ZealHire Inc

[email protected]

Reply to: [email protected]

Position: Data Governance (Healthcare Payer Claims)

Location: Remote

Duration: Long-Term Contract

Visa Status: Only USC/GC

Desired Years of experience:- 8 Years

Job Description:

USC/GC

Need LinkedIn and VISA DL

No VoIP or google numbers;
Last 5 digits of SSN required

Location: ***
Remote but need someone in one of the areas (or able to relocate to one of the areas if / when it becomes required) where they have an office.

Atlanta, GA; Bloomfield CT; Nashville TN; St. Louis, MS; Denver, CO; Dallas, TX; Austin, TX; Houston, TX; Boston, MA; Fairfax, VA; Morris Plains, NJ; Bloomington, MN; Philadelphia, PA; Scottsdale, AZ; Birmingham, AL.

Please read all of the notes so you are not wasting your time on this one. This has opened back up and the client wants to see more candidates.
She wants candidates with stronger claims data governance and business operations interaction/coordination.
This is NOT a Data Analyst or a Business Analyst or a PM
-
titles to circle around Claims/Governance Analyst, etc
. This is a Business side role. The client will not consider technical side candidates (architecture, ETL, UI, etc.,etc.)

NOTE: Important. Please read first so that you are not wasting time on the wrong candidates. The client wants to see

candidates with strong business operations experience and deep interaction with Healthcare Payer Claims Business Stakeholders. Please NO candidates that dont have heavy experience with claims transaction data experience. Looking for strong business side candidates, not technical candidates. No Business Analysts Data Analysts, PMs, etc
.

Top 3 Skills:

Deep understanding of

Healthcare Payer Claims Transactions / Claims Data,
and Business Operations

5+ years of healthcare payer claims experience.

Previous

Data Steward experience for a
Healthcare Payer/Insurer with
deep interaction with healthcare Payer Claims Business Stakeholders.

5+ years of Data Stewardship,

enforcing operational Data Governance data policies, standards, and rules in real-time
, across different data systems and sources. (Have dealt with
handling variety, velocity, and volume of data via a flexible, dynamic, and scalable approach.

Role Summary

The Claims Transaction Data, Data Steward is a member of a cross-functional
Data Governance team who partners with business, technical, and regulatory partners to ensure
the documentation and implementation of Claims Transactions data standards. The Data Steward leads complex, cross-organizational conversations including risk assessment, data quality auditing, issue management, and knowledge management to
ensure Claims Transaction data is fit for organization use
. Candidates should have a strong data management background understanding how data is organized and relationships maintained between data domains across multiple enterprise system with a strong drive towards improving data quality and governance.

Responsibilities

Serves as Data Steward as part of an Agile team dedicated to

Claims Transaction data operations & initiatives.

Leads Data Governance collaborations with Payer stakeholders to document, define, maintain, and manage Claims Transaction data standards and assets.

Assesses and monitors data quality metrics, analyzing trends and proactively promoting remediation and preventive action efforts.

Partners with IT and business teams to ensure the use of best practices and compliance with data standards.

Provides consultative stewardship services to delivery and issue resolution teams, serving as subject matter expert as needed.

Provides guidance on development, usage, and inventory of technical assets.

Represents GBS Data Governance in enterprise workgroups and data steward communities of practice.

Qualifications

Bachelors degree or higher

5+ years professional work experience in:

Data Stewardship, Data Governance, Data Management and Data Quality practices

Healthcare Payer Claims Transactions and Revenue Cycle operations

Claims Transaction data standards and operations, including:

Patient check-in and registration

Eligibility verification

Medical coding ICD-10, CPT, HCPCS, SNOMED CT - ASC X12N Implementation Guides

Claim submission

Claim processing

Claim payment

Claim reconciliation

Coordination of Benefits

Strong communications skills; written, verbal and presentation

Self-driven and able to function with minimal direction

Has the ability to engage business and data stakeholders to resolve questions or issues

Must have the ability to handle multiple and sometimes competing priorities in a fast-paced environment

Must be able to think creatively, innovate and flex where needed - quick/adaptive learner and collaborator/team player

Must have strong analytical and problem-solving capabilities

Able to strategize across complex, cross-functional projects and initiatives

Experience in Agile Methodology and tools (e.g., Jira, Rally, etc.)

Intermediate to Advanced data analysis skills and tools (e.g., SQL, SAS, Python, Hadoop, Teradata, Snowflake, Tableau, Collibra, Infosphere, Alation, etc.)

Keywords: user interface information technology green card trade national microsoft Alabama Arizona Colorado Connecticut Georgia Massachusetts Minnesota New Jersey Pennsylvania Tennessee Texas Virginia
Urgent Requirement for Data Governance (Healthcare Payer Claims) at Remote
[email protected]
[email protected]
View all
Tue Apr 23 23:20:00 UTC 2024

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