Senior Healthcare Data & Reporting Analyst (BI & EDI)

Role: Senior Healthcare Data & Reporting Analyst (BI & EDI)

Location: Baltimore, MD 21202 (Hybrid)

Duration: 12 months contract (Renewal for an additional year)

The agency seeks a Senior Systems Analyst (Reports) to support HBX and related systems through reporting, dashboarding, data extraction, EDI analysis, and database/reporting support.

Project Overview: Plan, design, develop, enhance, and maintain reports, dashboards, and data extractions; perform EDI data analysis; support HBX system reporting and reconciliation activities.

Job Description - Duties/Responsibilities:

• Design, develop, build, and manage complex, operational, and federally mandated reports.
• Identify from design, implementation, and post-implementation evaluation a variety of possible approaches for generating reports, dashboards, and data extraction requirements.
• Write a variety of complex queries in SQL for data extractions and develop reports in Tableau, and other tools using PostgreSQL and other databases as data sources.
• Identify opportunities for securely sharing commonly used data internally and externally.
• Interpret data, and perform data analysis for management decision-making, policy formulations, and review.
• Utilize database applications and analytical tools to evaluate data quality, and functions and maintain operations.
• Analyze the business processes to develop data solutions, reports, and dashboards to meet reporting requirements.
• Work with multi-disciplinary teams in a fast-paced, technically challenging environment delivering data to various internal and external stakeholders.
• Perform Medicaid 8001 Flat File validation and analysis, review multiple Member Person Index(MPI) for SSN matching and Master Data Management (MDM) matching.
• Perform HBX System Error analysis, validate 1095-A/1095-B files, and reconcile Medicaid 8001 transactions.
• Assist the development team, EDI operations team, and testing team in analyzing, fixing, testing, and transmitting EDI files on a daily basis.
• Create data change requests to fix consumer or system-reported errors, coordinate with technical and business teams to analyze error reports, and access the HBX database and application to perform root cause analysis for transaction rejections.
• Adhere to all security, change control, and Client’s Project Management Office (PMO) policies, processes, and methodologies.

Note: The candidate must be flexible to work overtime as needed, including weekends, holidays, and off-hours.

Minimum Qualifications:

• A minimum of five (5) years of experience performing complex data extractions, analysis, report generation, and dashboard creation.
• A minimum of five (5) years of experience working in a complex IT organization developing a variety of queries and custom reports utilizing SQL, stored procedures, and complex queries.
• A minimum of five (5) years of experience developing various reports and dashboards utilizing reporting tools such as Tableau, or PowerBI.
• A minimum of two (2) years of experience translating business requirements into effective data visualizations and dashboards.
• Experience in establishing and maintaining reporting databases and data warehouses.
• Knowledge of data modeling, data warehousing, and ETL processes.
• Effective communication and collaboration skills to work with stakeholders and technical teams.
• Demonstrated ability to manage multiple critical priorities and tight deadlines.
• Demonstrated analytical and problem-solving skills.

Preferred Qualifications:

• A minimum of eight (8) years of hands-on experience designing complex queries and reports using SQL and Stored Procedures.
• A minimum of four (4) years of experience developing queries and reports in the PostgreSQL database environment.
• A minimum of four (4) years of experience developing complex reports and dashboards utilizing Tableau, or equivalent.
• Extensive knowledge of data sources, data flow, data/system interactions, and advanced reports design techniques to develop complex analytical reporting solutions.
• Experience with developing reports and dashboards for the health insurance marketplaces, healthcare, or Health and Human Services domains.
• Hands-on experience with data visualization, data analysis, and report automation.
• Experience with web technologies, such as HTML, CSS, and JavaScript.
• Familiarity with programming languages such as Python, Java, or equivalent.
• Knowledge of EDI transaction sets such as 834, 820, and 999.
• Knowledge of Medicaid and Qualified Health Plan (QHP) eligibility rules.
• Knowledge of EDI 834 enrollment transactions, including Adds, Terminations, Cancellations, and life events.