Health Care Data Liaison

Job Description

Job Description

The mission of the Center for Health Information and Analysis (CHIA) is to monitor the Massachusetts health care system and to provide reliable information and meaningful analysis for those seeking to improve health care quality, affordability, access, and outcomes.  

This position performs data compliance review and analysis of data collected by CHIA from service providers within Massachusetts and payers for residents and employers of the state.  This requires close interaction with a wide range of internal and external parties including technical staff, data analysts, billing/coding staff, business unit staff and various levels of management.  Provides front line support on MA APCD and/or Case Mix Data Sets and other discharge/claim/cost level data, submission guidelines, definitions, data mappings and File Secure/CHIA Submissions usage. Ensure that variance standards are maintained and work to obtain the highest percentage of data possible. This position requires the ability to be a subject matter expert of the CHIA data specifications, rules and edits and the ability to communicate this information to the carriers/providers. Performs troubleshooting of data issues and identifies resolutions to both technical and non-technical problems. Work closely with programmers and other staff on updates and enhancements to the data collected and the edits performed.  

The Health Care Data Liaison will ensure the timely collection of payer and provider data/reports and recommend processes to improve project management efficiency. Under the direction of the Associate Director of Hospital Data Intake and Compliance, the Liaison will draft and edit memoranda, external communications, analytical reports and be involved in the development of new areas of data collecting and policy reporting for the agency.  

At CHIA, we foster a flexible, collaborative environment, offering a hybrid model that balances in-person and remote work. Our hybrid model includes working from our vibrant Boston office at 501 Boylston Street for at least two designated days per week, with the flexibility to work remotely on others. Specifically, as the Health Care Data Liaison, you will have the opportunity to: 

• Act as Liaison between the MA APCD and/or Case Mix submitters by providing front line support (telephone, email, teleconference and meetings) on MA APCD and/or Case Mix Data Sets and other discharge/claim/cost level data, definitions, data mappings and File Secure/CHIA Submissions usage. 

• Work with assigned carriers/providers in the initial set up and development of submitting MA APCD and/or Case Mix test and production data. 

• Work with assigned carriers/providers to receive, analyze and provide direction on Variance Requests to obtain the highest percentage of data possible and establish timelines for the carriers/providers to achieve threshold levels. 

• Work directly with the data submissions by querying and reviewing files and reports to assist submitters in problem resolution. 

• Assist carriers/providers in troubleshooting their submissions.  

• Assist carriers/providers in resolving both technical and nontechnical issues pertaining to the submission of MA APCD/Case Mix/Cost data, edits, errors received and data validation. 

• Identify issues pertaining to a submission and discuss with carrier/provider, assist with remediation strategy, and timeline for correction. 

• Work closely with stakeholders to understand their needs and uses, assist in monitoring whether the data submissions meet those requirements and standards. 

• Work closely with other teams to identify and resolve issues. 

1. Work with assigned analysts, business units, sister agencies in identifying and resolving issues pertaining to a submission, across submissions and across file types. 

2. Work with analysts, business units, sister agencies to interface with data providers to resolve   issues. 

3. Work with analysts, business units, sister agencies to assist in analysis and watch for defined outcomes. 

4. Work with data enhancement team and data release team to ensure quality and verification. 

• Serve as subject matter expert for data collection, file layout, field contents. 

1. Assist with and maintain data documentation development and maintenance. 

2. Assist with workgroup preparation, participation and support. 

3. Assist reporting groups to understand the data. 

4. Work with internal and external agency stakeholders to provide liaison support, arrange meetings between submitters and data users and provide outreach on data questions. 

• Educate the internal and external stakeholders on MA APCD and/or Case Mix data, submission formats and edits. 

• Participate in ad hoc projects related to team and agency-wide initiatives; this may include data analyses and quality assurance. 

• Consistently deliver high-quality services to internal and external stakeholders while continually seeking opportunities to increase customer satisfaction and deepen customer relationships. 

• Perform submission level QA on the data and assist data analysts in cleaning, validation, standardization, and creative analysis to ensure the best quality of data possible; assist in 

• business unit testing of updates/changes. 

• Identify potential processes for automation to assist in data compliance monitoring. 

PREFERRED QUALIFICATIONS: 

• Experience working with medical claims, membership, and associated data. 

• Experience in customer services for medical claims, membership, and associated data collection. 

• Experience working with large data files. 

• Ability to identify and forecast problems, explore answers, make recommendations, and initiate and execute solutions. 

• Demonstrated ability to evaluate data, to draw conclusions and make appropriate recommendations. 

• Ability to learn new software applications and techniques related to data submission and compliance. 

• Ability to develop rules for required edits and reports to effectively initiate change order requests. 

• Ability to translate needs, issues, and ideas into effective action plans. 

• Ability to manage workload to simultaneously make good progress on several projects with overlapping deadlines. 

• Ability to work independently and effectively with other members of the agency and the carrier/provider community. 

• Excellent interpersonal skills: verbal, written, and presentation. 

• Excellent documentation skills. 

Minimum Entrance Requirements:  

Analyst I 

Applicants must have at least (A) two years of full-time, or equivalent part-time professional experience in business administration, health care planning or administration, public health policy or administration, human services policy analysis or administration or economics, the major duties of which included financial analysis of costs, expenses and revenue and/or the development, implementation and monitoring of financial reimbursement systems, or (B) any equivalent combination of the required experience and the substitutions below.  

Substitutions:  

I. A Bachelor's or higher degree with a major in health care administration, hospital administration, public health or health services administration, accounting, business administration, business management, public policy, public administration or economics may be substituted for the required experience.  

Analyst II 

Applicant must have at least (A) three years of full-time, or equivalent part-time professional experience in business administration, finance, accounting, health care planning or administration, public health policy or administration, human services policy analyses or administration, economics, or a similar field; or (B) any equivalent combination of the required experience and the substitutions below.  

Substitutions:  

I. A Bachelor's degree with a major in health care administration, hospital administration, public health or health services administration, finance, accounting, business administration, business management, public policy, public administration, economics, or similar degree may be substituted for a maximum of two years of the required experience.*  

II. A graduate degree with a major in health care administration, hospital administration, public health or health services administration, finance, accounting, business administration, business management, public policy, public administration, economics, or a similar degree may be substituted for a maximum of three years of the required experience.*  

Analyst III 

Applicant must have at least (A) four years of full-time, or equivalent part-time professional experience in business administration, health care planning or administration, public health policy or administration, human services policy analyses or administration, economics, the major duties of which included financial analysis of costs, expenses and revenue and/or the development, implementation and monitoring of the health care service delivery system and pricing methods 

Substitutions:   

I. A Bachelor's degree with a major in health care administration, hospital administration, public health or health services administration, accounting, business administration, business management, public policy, public administration, economics, or similar degree may be substituted for a maximum of two years of the required experience.*  

II. A graduate degree with a major in health care administration, hospital administration, public health or health services administration, accounting, business administration, business management, public policy, public administration, economics, or a similar degree may be substituted for a maximum of three years of the required experience.*  

*Education toward such a degree will be prorated on the basis of the proportion of the requirements actually completed.  

Total Compensation: 

We value the talent and expertise you bring to the table. We offer a competitive salary range of $62,782.98 - $120,508.44 annually for this position. Salary is commensurate with experience. CHIA may adjust title, responsibilities, and salary depending on the experience and expertise of the individual selected.    

Comprehensive Benefits:   

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.    

Want the specifics? Explore our Employee Benefits and Rewards!    

Together, let's embark on a journey of meaningful impact in healthcare. We invite you to join CHIA, where your expertise will shape the future of healthcare in Massachusetts. Likewise, we're eager to take a chance on you - to welcome a dedicated professional who shares our passion for making a difference. Join us in this collaborative endeavor, where we'll forge new paths, innovate, and lead the way toward a healthier Commonwealth.   

Apply now and be part of transforming health policy at CHIA!    

NAGE: Reimbursement Systems Analyst I (RSA I), Reimbursement Systems Analyst II (RSA II), Reimbursement Systems Analyst III (RSA III). 

The full salary bands:   

Analyst I/ RSA I: $62,782.98 - $89,679.72 annually.  

Analyst II/ RSA II: $72,172.36 - $104,315.38 annually. 

Analyst II/ RSA III: $82,789.72 - $120,508.44 annually.   

An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply. 

An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.

Information submitted by applicants is collected through the JazzHR Platform, your submission of application materials constitutes your express consent for this information to be provided to JazzHR for processing. Please do not include any personally identifiable information with your application materials other than that specifically requested by CHIA. CHIA requests basic information such as name, address, telephone number, and email address. You may also self-identify with your race/ethnicity, gender, disability and/or veteran status. However, you should not provide more detailed personal information such as your date of birth or Social Security Number with your application materials.

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