Overview:

Our client is a health insurance company. It offers different types of health care coverage plans that include individual and family, dental and vision, plans for employers, etc.

Engagement Description:

Resource will be responsible for validating certificates and rider bundles for medical plan renewals, reviewing renewal test results, and coordinating conversations with multiple business teams to determine what actions need to be taken to mitigate issues identified in renewal testing to ensure plan renewals execute successfully.

Ability to plan, organize, direct, control and lead your own projects and responsibilities with limited oversight. Additionally, responsible for helping bridge the gap between business opportunities and technology solutions, evaluate technical design as well as assist with hands-on implementation of business capabilities across the Market Solution domain.

Strong communication skills, project management, and SQL development are required. Experience in healthcare or similar big data environment is preferred.

Top 3 Required Skills/Experience

Ability to validate and troubleshoot IT test results via application of business rules
Ability to lead business discussions with multiple business areas to troubleshoot issues
Data-oriented, process-oriented, and cross-functional collaborative approach to troubleshooting issues

Required Skills/Experience The rest of the required skills/experience. Include:

Utilize data analytics and extensive business knowledge to research, analyze, identify, and evaluate data to troubleshoot and identify problems
Possess and maintain in-depth knowledge of Client business, products, programs (including claims, reimbursement, benefits, provider and program data, networks, etc.), corporate organizational structure (including functional responsibilities), and complex research principles/methodologies.
Design new reports and interfaces using advanced queries and software solutions. Maintain existing reports and process automation tools.
Improve and automate existing manual reporting processes.
Create documentation to formalize reporting processes.
Collaborates with solution team (business leads, PMO, architecture & technology) from ideation phase onward to:
Shape and guide solution development, recommend best fit technology/design that is compatible with business, evaluate risk and delivery constraints
Collaborate to scope requirements to ensure optimization, scalability and reusability of capabilities and business value
Create operation readiness and group setup processes across solutions portfolio
Consult with domain/project/program teams to incorporate best practices, ensure compatibility with existing/new solutions, infrastructure, and services.
Analyze the current business & solutions architecture of Market Solution product suite to identify weaknesses and develop opportunities for improvements. Engaging in conversations with business partners to identify requirements, needs and gaps aimed at technology driven transformation.
Provide technical expertise in organizing and storing large scale data, data mining, and data sanitization.
Responsible for special project and/or problem resolutions.
Provide technical expertise in organizing and reviewing moderate datasets, performing test validation through formulas in Excel, and data sanitization
Strong structured and analytical problem-solving skills will be critical
Must be able to provide analytics leadership to the team
Should be able to adapt quickly to our data infrastructure
Strong communication skills, project management, and advanced knowledge of Microsoft Excel / Microsoft Access
Six (6) or more years' professional experience

Preferred Skills/Experience Optional but preferred skills/experience. Include:

Previous work experience in insurance is preferred
Microsoft Access database development and support of tables, forms, queries, and modules.
Ability to write and interpret VBA (Visual Basic for Applications) code.
Knowledge of Microsoft SQL Server 2016 database development and support
Experience developing user data visualization tools, graphs, infographics, and other methods of presenting data.
Background with developing and supporting Microsoft SQL Server Integrated Services (SSIS) packages
Experience with SQL Server Management Studio
Experience developing queries, views, etc. on Oracle
Excel Macros, MS Office suite, Visio, SharePoint, DB2 databases, other PC database tools, other PC development languages.
Experience developing dashboard reporting in Tableau
Experience with other reporting and data analysis tools such as SSRS.
Experience with Informatics Environment, Including writing queries in HUE, and Impala.
Data Architecture Framework experience
Experience performing complex data analysis on large data sets
Strong structured and analytical problem-solving skills will be critical. Must be able to provide analytics leadership to the team. Should be able to adapt quickly to our data infrastructure through a strong working knowledge of SQL.

Education/Certifications Include:

Bachelor's Degree in Business Administration, Accounting, Economics, Health Care, Information Systems, Statistics, or other related field is required.
Master's Degree in related field preferred.