University of Massachusetts Medical School

  • Analyst, Program Integrity Data

    Minimum Salary US-MA-Charlestown
    Job Location 2 weeks ago(2 weeks ago)
    Requisition Number
    2018-31494
    # of Openings
    1
    Posted Date
    Day
  • Overview

    GENERAL SUMMARY OF POSITION:

     

    Under the general supervision of the department head, or designee, the Data Analyst will conduct data analyses and develop/ produce all related reports.  This position will provide information to leadership regarding state of the art data management systems and opportunities to enhance analyses, system integration and related databases.

    Responsibilities

    MAJOR RESPONSIBILITIES:

    • Design and develop data collection instruments, databases and procedure manuals based on thorough knowledge of data files, related databases, and systems integration
    • Design and implement data management and quality control procedures, including writing technical requirements and documentation of data sets
    • Participate in project meetings related to data analysis and management
    • Produce and report data analysis reports. May be required to provide tabular and graphic summaries of analyses in a form suitable for inclusion in manuscripts for publication in peer reviewed scientific journals as well as for presentation at scientific meetings
    • Conduct in-depth analysis of project data, performing computations with a high degree of independence
    • Ensure accuracy of reports by data review and resolving discrepancies internally for assigned reports
    • Provide interpretation of data to senior management
    • Provide periodic reports to management regarding status of assigned projects and recommend corrective actions when necessary
    • Schedule, plan, coordinate, and review project activities related to data
    • Review and monitor compliance with the federal and state regulations
    • Perform other duties as required

    Qualifications

    REQUIRED QUALIFICATIONS:

    • Bachelor’s degree in a business, health sciences, or a related field or equivalent
    • 4 years of related experience
    • Demonstrated experience/skills in appropriate computer, statistical or database applications
    • Demonstrated ability to research issues and resources; basic record-keeping and organizational skills
    • Demonstrated ability to write reports, journal articles and/ or other technical documents
    • Excellent communication, both oral and written
    • Interpersonal skills necessary to interact successfully with a wide range of individuals

    Additional Information

    Commonwealth Medicine (CWM) is the consulting division of UMass Medical School.  The CWM Center for Health Care Financing (CHCF) helps state and local governments, primarily in Massachusetts, identify opportunities to increase savings and reimbursements through federal and other third party sources, establish effective savings and reimbursement programs and capitalize on all possible revenue streams. We identify opportunities for our clients to increase services and reduce the net cost of delivery.


     


    The SSI State Supplement Program (SSP) is a joint program of the Executive Office of Health and Human Services (EOHHS), the Department of Transitional Assistance (DTA), and the Mass Commission for the Blind (MCB).  The SSP provides state-funded supplemental payments to eligible aged, disabled and blind SSI recipients and to low income clients who are eligible for SSI but for income.  SSP eligibility is an eligibility factor for certain related benefits, including SNAP and MassHealth.


     


    CHCF began administering the SSP on behalf of the Commonwealth of Massachusetts in April, 2012.  The implementation process is planned on an evolving multi-year schedule, comprising several phases of enhanced and additional operations.  Our responsibilities include program management and operations, eligibility determination, payment calculation and issuance, client services, outreach projects, program integrity, quality control and ongoing program development.   Program administration is dynamic, fast-paced, and continually progressing; success will require multi-tasking, internal and external collaboration, and the ability to meet deadlines and work under pressure.  


     


    The State Supplement Program (SSP) is seeking experienced program integrity specialists to detect and research improper payments and potential eligibility fraud by collecting and analyzing data.  SSP is a state-funded cash assistance program administered by the UMass Medical School's Center for Health Care Financing on behalf of the Department of Transitional Assistance.  Program administration comprises ongoing daily operations as well as development and implementation of new initiatives and program enhancements. Operations are dynamic, fast-paced, and continually progressing; success will require multi-tasking, team collaboration, independent judgment, and the ability to meet deadlines and work under pressure. 


     


    PREFERRED QUALIFICATIONS:



    • Demonstrated experience/skills in SQL strongly preferred.

    • Thorough working knowledge of DTA, Social Security, Medicaid and Medicare regulations, data, and programs.

    • Demonstrated expertise in data matching and analysis, focused on fraud detection, prevention, and investigation.

    • Successful experience in interpreting state and federal regulations as they apply to public assistance programs, monitoring compliance with program rules, and working with confidential data.

    • Experience providing interpretation of data in appeal proceedings.

    • Demonstrated ability to apply quality improvement initiatives in daily operations and to identify quality or system issues.

    • Successful experience in program start-up as well as ongoing operations.


     

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