Apply on line at http://www.alohacare.org/Careers/Default.aspx
AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.
AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication and a generous benefits package.
AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.
These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.
Support AlohaCare’s finance department in the retrieval, analysis and reporting on data to assist management in making well informed financial decisions. Conducts ad hoc analyses, prepares reports and presents information.
Primary Duties & Responsibilities:
• Designs and develops database queries, extracts data from databases and analyzes the data using a variety of analytical techniques. Prepares accurate reports and presents findings.
• Performs utilization analysis utilizing data from different sources and reports results.
• Provides data and analytical support for department and organizational initiatives.
• Maintains medical and drug utilization dashboard
• Manage and monitor monthly inpatient expense report.
• Manage and calculate Medicare broker commissions. Responsible for maintaining an accurate record of payments and preparing monthly payments and reports.
• Analyzes and interprets Medicaid & Medicare encounter data to identify potential issues and trends.
• Coordinates with other department and performs the correction of encounter data rejections so that files may be resubmitted, error free.
• Monitors daily administrative duties of the encounter data process. This includes key point of contact with encounter application vendor regarding encounter processing, direct response to external and internal customers’ issues which may arise, ensuring resolution.
• Analyze, review, forecast and trend complex data from various sources.
• Balances key financial metrics, including claims to encounters and participates in rate setting efforts
• Prepare reports as needed.
• Performs other duties as assigned.
• Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.
Required Competencies & Qualifications:
• Bachelor’s Degree with emphasis in computer science, information systems, mathematics, statistics, public health, health sciences, data analysis, accounting or health care administration
• 2-3 years professional training or work experience which demonstrates the ability to perform the duties required for the position.
• Equivalent combination of education and experience
• Prior experience using Access, SQL, Excel and other statistical/analytical tools.
• Knowledge of relational databases and structures.
• Strong analytical, critical thinking and problem solving skills.
• Experience with computer systems and software programs (e.g. SQL, reporting tools, Microsoft Office, and Stata/SAS/SPSS or equivalent statistical package).
• Excellent interpersonal skills and ability to work with cross functional teams.
• Ability to work independently with minimal supervision.
• Achieves results, builds trust, communicate effectively, detail-oriented, and customer and quality focused.
• Ability to multi-task, organize, adapt to changing priorities, and manage a diversity of high priority projects in a fast-paced environment.
• Strong work ethic with a positive, can-do attitude
• Requires operation of general office equipment to include; PC, fax/copy machine and ACD Mitel Phones.
• Advanced skill using Microsoft Programs; Word, Excel, Access, PowerPoint and Outlook
• 3-5 years related experience or equivalent.
• Health care industry experience within managed care, hospital, medical office or equivalent preferred.
Physical Demands/Working Conditions:
• Inside working conditions.
• No environmental hazards.
• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.Position Description »