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. Shares data analysis expertise, experience and findings with other team members and provides guidance to new and less experienced staff. Works under moderate supervision. Education: Bachelor's degree in Computer Science, Business, health-related or related quantitative discipline, or equivalent work experience required. Master's degree preferred. Experience: Minimum of three years performing encounter data analysis of Risk Adjustment Processing System (RAPS), Encounter Data Processing System (EDPS) and All Payer Database (APD) or analysis of healthcare claims, members and provider data, in a managed care organization required. Proficiency in standard business applications such as Microsoft Office suite required. Proficiency in data analysis software such as SAS or SQL required. Demonstrated strong analytical and reporting skills required. Excellent verbal and written communication and analytical skills required. Demonstrated ability to work in a team-oriented environment interacting with all levels of staff required. Demonstrated ability to work autonomously and effectively prioritize and execute tasks independently with minimal supervision 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.