To be considered, email your resume and cover letter to Karen Chang at kchang@hsmnetwork.org.
Department: ADMINISTRATIVE SERVICES
Location: Tallahassee, Florida
Starting Salary Range: $55,000-$60,000
Employee Type: Full-Time
Status: Exempt
Reports To: Director of Informatics
JOB SUMMARY
Join a dynamic team where every day you can make positive impacts on the health of new mothers, babies, and their families. Our team provides support for services statewide to help give every baby a healthy start in life.
Under the general direction of the Healthy Start MomCare Network, Inc. (HSMN) and the Florida Association of Healthy Start Coalitions (FAHSC) Chief Operations Officer, the Data Manager of State Grants will compile, analyze, and interpret data to ensure Healthy Start program and other state funded program compliance with contract requirements, while identifying trends and addressing issues to optimize program efficiency.
The location for this position is the HSMN office at 2002 Old St. Augustine Rd. Suite E-45, Tallahassee FL, 32301 with opportunities for remote work.
BENEFITS
• Dental insurance – employee eligible as of first day of employment
• Health insurance – employee eligible as of first day of employment
• Life insurance
• Generous Paid Time Off
• Retirement plan
• Vision insurance
DUTIES & RESPONSIBILITIES
- Reporting to state funder
• Maintain working knowledge of contract requirements for all state agreements.
• Generate reports from the Healthy Start case management system as required for contractual compliance; monthly, quarterly, annually, and ad hoc. - Healthy Start Coalition Earnings and Medicaid Claims
• Extract and gather necessary data and claims information from the Healthy Start Billing System and database for analysis and preparation of provider payment statements.
• Reconcile claim earnings to the funder’s remittance advice.
• Prepare and submit all payment statements to providers.
• Track all payments, earnings, and contract cap balances for each provider, and provide summary reports as needed by leadership.
• Provide technical assistance and claim analyses as needed to our providers. - Provider Contract Caps
• Prepare data files for the process of resetting provider contract caps twice yearly.
• Assist as needed in the preparation and analysis of the final reset of the contract caps. - Claims Quality Assurance Audit
• Research paid claims in the Healthy Start billing system and in the State FMMIS, to ensure payment was appropriate.
• Provide technical assistance and recommendations to providers by identifying claims that were incorrectly submitted or not submitted, to maximize revenue.
• Communicate/coordinate with Director of Analytics and Chief Operations Officer to resolve claims. Document claims research activities, report claims resolution results and report on current practices and recommendations for improved claims processing and resolution practices for HSMN and Healthy Start Coalitions.
• Prepare quarterly audit reports for Leadership and the Executive Board. - Quality Assurance (QA) and Continuous Quality Improvement (CQI) efforts.
• Research and analyze Medicaid claims and Healthy Start services, to determine statewide trends and potential missing or incomplete data.
• Develop a statewide report card on critical metrics. - Maintain and manage HSMN assigned agent roles in the Florida Medicaid Management Information System (FMMIS)
• Annually update list of FMMIS users from coalitions.
• Provide FMMIS access timely and as necessary, and ensure technical assistance is provided for usage. - Perform other duties as assigned.
REQUIREMENTS
• Bachelor’s degree majoring in a relevant discipline (e.g., Mathematics, Economics, Statistics, Computer Science, or related field).
• At least two years of overall data analysis experience with at least 1 year analyzing claims data.
SKILLS:
• Strong critical thinking skills.
• Basic SQL skills, with the ability to perform efficient and effective querying involving multiple tables and subqueries.
• Advanced knowledge and experience with Microsoft Excel (VLOOKUP’s, pivot tables, functions, as examples) and Microsoft Word.
• Effective verbal, written, and interpersonal communication skills.
• Ability to organize independently and successfully assigned work priorities and activities and to complete tasks in a timely manner.
• Proficiency in virtual meeting platforms, such as Zoom and Microsoft Teams.
OTHER:
• Local and statewide travel is required to attend meetings.
• Must have a valid driver’s license, a safe driving record, have reliable transportation and carry your own car insurance; and
• Upon hiring, the candidate will be fingerprinted, and a background screening will be conducted.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit, talk, hear, and use hands and fingers to operate and handle keyboards and controls. The employee is occasionally required to walk and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job.