Encounters Data Analyst, Assoc

The position provides analytical and business support for the Encounter Operations Department. Performs reporting and data analysis, and works with the Encounters Team to provide recommendations to improve Encounter Data processing efficiency, quality, assuring compliance, and adherence with regulatory guidelines.

Essential Functions:
  • Communicate with internal and external business partners and vendors to obtain information and documentation needed to support business needs.
  • Assists team with research and technical data support for regulatory/business-oriented processes for Encounter Data Operations.
  • Assists with the review, research, investigating and correcting of encounter issues through data and process analysis.
  • Performs analysis and data mining for encounter data reporting requests from internal and external customers.
  • Performs other duties as assigned.
Additional Responsibilities:
  • Performs analysis of identified defects or issues through system testing.
  • Communicate and manage provider/vendor and Ancillary regarding encounter deliverables to ensure compliance to state SLAs.
  • Performs analysis of identified defects or issues through system testing and provide solutions.
Candidate Education:
  • Required A Bachelor's Degree in a related field with demonstrated exposure to relevant programming languages (i.e. SAS, SQL, VB.NET, Oracle, or similar)
  • Required or equivalent work experience 2 years of relevant software experience to include SAS, SQL, VB.NET, Oracle, or similar
Candidate Experience:
  • Required 1 year of experience in Data analysis, research or reporting/analytics, preferably in a health care environment
  • Preferred 1 year of experience in Pharmacy background/knowledge of PBM
Candidate Skills:
  • Intermediate Ability to communicate and make recommendations to upper management
  • Intermediate Demonstrated analytical skills
  • Intermediate Demonstrated interpersonal/verbal communication skills
  • Intermediate Demonstrated written communication skills
  • Intermediate Demonstrated problem solving skills
  • Intermediate Ability to work in a matrixed environment
  • Intermediate Ability to work as part of a team
Licenses and Certifications:
A license in one of the following is required:
    Technical Skills:
    • Required Intermediate Microsoft Excel
    • Required Intermediate Microsoft PowerPoint
    • Preferred Beginner SQL Server System SQL

      About us
      Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.