Senior Data Operations Analyst

Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest-growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 700 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.The Healthcare Finance (HCF) department exists to monitor and improve the financial performance of Kelsey-Seybold’s (KS) product lines and health plans. The HCF Analytics team is a customer service-focused department providing consultation to the KS executive team as well as to select operational and functional departments. The HCF Analytics team works closely with internal and external partners toidentify revenue and cost savings opportunities, support new product and business development, ensure regulatory compliance, inform contract negotiations, and complete the reconciliation of incentive arrangements, claims, capitation, and premium payments with other payers, vendors and/or government entities. The HCF department is adequately staffed by highly skilled, motivated, and inquisitive individuals that deliver a complex analysis of financial and utilization data to support revenue enhancement and identify cost savings opportunities. The Senior Analyst will provide data, systems support, and analysis related to risk adjustment and quality data submissions. The team operates the CMS Encounter Data and HEDIS vendor software solutions and implements reporting and analysis specific to Medicare riskadjustment, RAPS, EDPS, and HEDIS. The team analyzes and researches all encountered data errors and submission issues, collaborating with internal departments to work toward error resolution. The Senior Analyst is able to independently identify areas requiring investigation, define and perform analyses, and recommend solutions with little to no guidance.Key responsibilities of this position include:• Encounter Data Analyst: Creating submissions and evaluating encounter data to identify errors created by operational, claims, and eligibility processes. Working with cross-functional teams to resolve errors and ensure the completeness and accuracy of submissions.• HEDIS/Quality Reporting Analyst: Mapping, verifying, and loading HEDIS data sources to calculate and measure results and prepare member-level detail to support audited reporting and quality improvement initiatives.• System Support Analyst: Helping to develop and maintain the systems and processes that are the foundation of risk adjustment and quality data operations• Report Writer: Developing, producing, and analyzing reports and data required to understand submission status and rejection issues related to risk adjustment and quality data submissions. Acting as a subject matter and technical expert for more junior analysts

Requires:Bachelor’s Degree in Finance, Economics, Mathematics, Healthcare Administration, Computer Science, or a related field5+ years of experience in data analysis, decision support, medical economics, healthcare informatics, or managed healthcare or equivalent combination of education and experience to demonstrate the ability to succeed in data operations.SQL experienceRisk Adjustment experienceHEDIS or Risk Adjustment SubmissionsDemonstrated initiative and problem-solving skills with the ability to convert raw data into actionable business insights.Demonstrated data extraction and transformation skillsAdvanced proficiency in Microsoft Excel. 3+ years’ experience with SQL or other programming tools (including Visual Basic and Excel macros)Experience writing, debugging, and documenting complex queries against relational databases.Basic knowledge of Microsoft PowerPoint and Microsoft WordFluent in English both verbal and written and effective communicator.High level of accuracy with excellent attention to detail.Strong organizational and time management skills. Proven ability to work in a dynamic setting and balance multiple priorities while meeting deadlines. Superior analytical skills. Ability to communicate complex information in a clear and concise manner

Why Kelsey-Seybold Clinic?

• Medical, Vision, and Dental
• Tuition Reimbursement
• Company Matching 401K
• Employee Reward and Recognition Program
• Paid time off for vacation, sick, and holidays
• Employee Assistance Program
• Continuing Medical Education allowance

Kelsey-Seybold Clinic strives to provide equal opportunity employment without regard to race, color, religion, age, national origin, sex, gender, sexual orientation, gender identity/expression, genetic information, disability, veteran status, or any other basis protected by organizational policy or by federal, state, or local laws unless such distinction is required by law. Kelsey-Seybold is a VEVRAA Federal Contractor and desires priority referrals of protected veterans.