Evaluates encounter data and identifies errors created by operational, claims and eligibility processes. Researches, analyzes, summarizes and categorizes encounter rejects from CMS and NYSDOH. Works closely with other departments, delegated vendors and government agencies to monitor, analyze and communicate aggregate and individual encounter data metrics. Provides administrative, organization and technical support to the department in the tabulation and analysis of data.
Retrieves, compiles, reviews and ensures accuracy of encounter data from VNSNY CHOICE systems and delegated vendor sources, as needed.
Summarizes large volumes of encounter data in analytical reports that include tables, graphs, qualitative and quantitative analyses for management review and use. Reviews and ensures accuracy of reports and corrects discrepancies.
Assists in the development of reports and projects, including documenting methodology, protocols, analysis, and design. Recommends and implements efficient means of data collection and maintenance.
Programs using SAS, SQL or other appropriate software to generate reports based on input/direction from management and other report users.
Collaborates with other departments and vendors to identify missing data, errors or other anomalies; works with them to correct these encounter data errors, gather necessary information and provide guidance on regulatory reporting needs.
Monitors encounter data integrity of various databases and creates monthly, quarterly and ad-hoc reports.
Initiates and maintains internal contacts to secure current/correct encounter data necessary for clear presentations of all reports, special projects, etc.
Performs special projects and other duties as needed.
Education:Bachelor’s degree in Computer Science, Business, health-related or related quantitative discipline, or equivalent required. Master’s degree preferred.
Experience:Minimum of one year performing encounter data analysis of RAPS, EDPS & APD, in a health care or health plan organization, required. Proficient personal computer skills, including MS Excel, Access and Word, required.Strong SAS and or SQL program coding required. Strong analytic and reporting skills required. Knowledge of Edifecs preferred. Effective oral, written and interpersonal communication skills required.
The Visiting Nurse Service of New York (VNSNY) is the nation's largest not-for-profit home- and community-based health care organization, serving the five boroughs of New York City, and Nassau, Suffolk, and Westchester Countries. For over 125 years, VNSNY has been committed to improving the health and well-being of people through high-quality, cost effective healthcare in the home and community. We offer a wide range of services, programs, and health plans to meet the diverse needs of our patients, members, and clients from before birth to the end of life. Each day, more than 13,000 VNSNY employees - including nurses, rehabilitation therapists, social workers, other allied professionals, and paraprofessionals - deliver compassionate care, unparalleled medical expertise, and 24/7 solutions and resources to more than 44,000 patients and members, helping them to live the best lives possible in their homes and communities.