Analyzes and implements information systems to manage financial functions for Patient Financial Services/Accounts. Ensures systems compliance to applicable laws, regulatory standards and policies.
Implements the information system initiatives to meet user requirements; communicates with user departments and project teams regarding implementation activities and system changes to ensure feasibility; develops system specifications that appropriately meet department requirements.
Assesses the patient management inpatient and outpatient registration pathways for constant improvement and enhancement; incorporates financial regulatory requirements; administers system support for patient management system users; evaluates information technology to promote operational efficiency and financial reimbursement.
Oversees managed care contracts; compiles and tracks managed care financial and statistical information related to contract development and financial impact analysis; maintains rate database and contractual terms of managed care contracts (prosthetics and implants, MR copying charges, etc.).
Develops systems to track data in comprehensive and innovative ways; collaborates with hospital departments and outside vendors to facilitate managed care contract implementation; facilitates the implementation of managed care contracts.
Responds to inquiries and interprets contract language as it relates to managed care; coordinates and maintains communication between the hospital and vendor(s) regarding system applications; coordinates communication with the vendor representative regarding enhancements, issues, etc. for the system applications.
Reviews contractual obligations, ensures status of deliverables, and resolves related issues; performs periodic post-installation reviews of system initiatives.
Reviews and evaluates post-installation processing per documented specifications; creates ad-hoc reports to ensure system builds are functioning according to specifications and ensures accurate payments.
Develops and conducts in-services for Patient Financial Services/Accounts; creates appropriate in-service training materials.
Conducts system-wide in-services with managers and staff, as necessary; ensures systems compliance to applicable laws, regulatory standards and policies.
Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action.
Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
Bachelor's Degree required, or equivalent combination of education and related experience Minimum of two (2) years of experience with Apache Hadoop, NoSQL, setting up cloud clusters, Apache Spark, and other advanced data science and big data technologies, required.
Experience in software development in enterprise/ web/ cloud applications, solutioning, architecture and frameworks.
Big data expertise with cloud and enterprise level design/implementation.
Experience in architecting data warehouses and/or data lakes with traditional database enterprise-class RDBMS technologies.
Strong knowledge of programming languages/tools including: Java, Python, Spark, SQL, R, and Shell Scripts.
advanced proficiency in excel and red cap - preferred