Contract Information Management Analyst III Must Live on the Island of Oahu
In addition to the responsibilities listed below, this position is also responsible for supporting contract data organization and abstraction by identifying and capturing standard and nonstandard data, reconciling common discrepancies, and submitting corrections for contractor and contract data to aid downstream contracting processes; submitting provider demographic updates and contract rules, rates, and term updates for simple-to-moderately complex contracts to the appropriate systems of record; creating and/or updating the provider data and contract configuration spreadsheets as directed; conducting standard and non-standard analyses of provider and contract data to develop recommendations for improvement initiatives; and engaging in the implementation of process improvement initiatives to aid providers and business goals. This role is also responsible for contributing to provider satisfaction by leveraging comprehensive foundational knowledge of provider and contracting data to support contract managers on issues that arise from contract configuration/interpretation and/or related to referral, claims/disputes, billing, payment, reimbursement, directories, and other operational issues; contributing to tasks to ensure requests for information, questions, and problems are identified, documented, and addressed in a timely manner; ensuring contract commitments are met by organizing provider and contract data in appropriate platforms and supporting the consultation of provider compliance; documenting provider activities and/or supporting the collaboration with alternate stakeholders to ensure compliance with contract terms and conditions; reviewing existing simple-to-moderately complex provider and contract data to ensure compliance with state and federal regulations as well as KP policies and procedures; and consulting with internal stakeholders as needed to ensure proper contract interpretation and operational readiness and supporting corrective actions as identified through contract performance.
- Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.
- Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.
- Contributes to data abstraction by: identifying and capturing key standard and nonstandard administrative and clinical data elements, such as patient data; reviewing medical records to identify standard and nonstandard data required for secondary use; reviewing regulatory requirements to ensure changes are integrated correctly (e.g., metric changes); leveraging information from electronic health records and uploading for use and reduction of abstraction needs; and transferring data as needed for typical or routine data transfers.
- Contributes to overall data process and maintenance by: contributing to entering, maintaining, and reconciling data; verifying accuracy of information in collaboration with the team; and responding to standard and nonstandard requests for data from various departments to support business processes.
- Supports or leverages data processing by: conducting routine and nonroutine data uploads; maintaining and contributing to the organization and verification for a variety of data; and reconciling moderately complex discrepancies between data sources and escalating issues to a supervisor/manager as needed.
- Ambiguity/Uncertainty Management
- Attention to Detail
- Business Knowledge
- Communication
- Critical Thinking
- Cross-Group Collaboration
- Decision Making
- Dependability
- Diversity, Equity, and Inclusion Support
- Drives Results
- Facilitation Skills
- Health Care Industry
- Influencing Others
- Integrity
- Learning Agility
- Organizational Savvy
- Problem Solving
- Short- and Long-term Learning & Recall
- Teamwork
- Topic-Specific Communication
- Applied Data Analysis
- Business Relationship Management
- Compliance Management
- Consulting
- Contract Management
- Data Entry
- Data Integration
- Health Care Reimbursement
- Provider Data Systems/Processes
- Quality Assurance Process
- Health Records
- Medical Terminology
- Operations Management
- One (1) year of experience working with provider data or in provider contracting or related experience.
- Two (2) years of experience working in a role requiring high volume data entry.
- One (1) year of experience in data analysis.
- Bachelors degree in Business Administration, Health Care, Information Systems, Human Resources, Operations Research, Public Health Administration, or related field AND Minimum three (3) years of experience in health care data analysis, relational database management, business process improvement, training delivery, clinical research or a directly related field, OR Minimum six (6) years of experience in health care data analysis, relational database management, business process improvement, training delivery, clinical research or a directly related field.
- Registered Health Information Credentials, Technician.
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