The Domain SME Informatics Senior Specialist is responsible for supporting a Solution Vertical from within the Enterprise Reporting organization. This role will provide support to the Solution Vertical stakeholders to achieve enterprise goals and will be responsible for gathering and developing / executing (coding) on the ER Domain Analysts’ package (runbook) that contains the full integrated business requirements. This role will be supporting all CIMA-owned applications in support of the visions and strategies established by the Informatics Manager.
INFORMATICS CONSULTATION AND REQUIREMENTS ENGINEERING
- Provide expert consultation to improve on data availability, data collection, reduce operational costs content and quality.
- Demonstrate and maintain deep breadth of knowledge on all product types and business processes; using business knowledge to determine project requirements, resolve business issues and identify changes or barriers which affect project design.
- Support management in the long-term strategy and defining of priorities.
- Participate in workgroup meetings across functional areas to identify quality improvement opportunities that will lead to better ways to profile providers.
- Communicate analytical findings/gaps/solutions to management and offer solutions to meet gaps.
- Collaborate with IT partners to ensure new development, enhancements or fixes meet business needs. This includes writing functional requirements, actively participating in system design reviews, reviewing test evidence, participating in status meetings, and providing monthly updated requirements and methodologies for foundational tables/views.
- Identify data sources and data elements needed for new reports, and enhancements to existing reports, and appropriate data sources.
- Work with teams to review, analyze, and design processes to improve data efficiency and scalability, then develop a plan to move this new process into production while working with teams to write the business and technical specifications, write code, and ensure data quality.
DATA MINING, RAPID PROTOTYPES, AD HOC ANALYSIS, AND CUSTOM REPORTS
- Develop and deliver complex projects or report solutions in response to customer inquiries.
- Prepare monthly data extracts from source systems in support of analytic health scoring algorithms, claims extract analysis, and Total Health & Network reporting.
- Prepare performance reports (used by the business to drive strategic decisions) book of business, client supplemental report/scorecard, prospective client reports, healthcare vendor quality reports, and utilization accreditation (ie URAC).
- Prepare detailed operational reports such as ad-hoc reporting, pilots, and tactically-oriented, daily-to-monthly reports.
- Lead and develop new and improved reporting and metrics to provide insights into a team’s operational effectiveness.
- Work productively in a fast-paced environment that requires constant development of data-related technical skill sets across a distributed data architecture (including SQL Server, Visual Basic.Net, QMF, Excel, Access and other relevant software applications such as SAS and SQL).
DATA VALIDATION AND SUSTAINED OPERATIONS
- Ensure customers are satisfied with the accuracy, timeliness, and reliability of data frequently being provided.
- Ensure quality and integrity of data collected, analyses performed, and reports generated.
PRODUCTION MANAGEMENT AND TALENT DEVELOPMENT
- Coordinate and perform project tasks including completion of key documents (e.g. requirements docs, project plans and master trackers for program governance and reporting) with high-quality and on-time delivery.
- Manage informatics projects for medium to large projects, including enhancements.
- Communicate statuses, good and bad, to partners to keep them informed and engaged in the project, minimizing surprises.
- Take quick, decisive, informed action on issues or problems judged as critical.
- Work effectively and efficiently on multiple tasks and deadlines, while producing high quality results.
- Demonstrates good judgment, weighs risks, and take on new challenges and responsibilities.
- Strong business acumen that can be leveraged in order to discuss business objectives and technology as well as underlying data required to support product needs.
- Self-starter with an excellent analytical and technical background, experience in application development and systems analysis, as well as project management skills in a matrix organization.
- Effective at recognizing barriers, problem solving in a complex organization, and providing strategy toward resolution.
- Excellent interpersonal and customer service skills, communication skills with demonstrated ability to influence internal and external resources at multiple levels.
- Versatile contributor who can work effectively when independent, within a team, or among matrix partners with minimal guidance while managing multiple tasks and meeting aggressive deadlines.
- Ability to navigate organization, build SME relationships and assist with internal discussions and effectively represent subject matter expertise.
- Ability to mobilize and motivate matrix team towards a common vision and common set of objectives.
- Able to quickly size-up scope of project to accurately assess timing and costing.
- Acts as mentor to team members to enhance their knowledge and skills.
- Minimum of 5-7 years’ experience in health care/managed care with direct responsibility for analysis and data management with relational database concepts and reporting with strong preference for backgrounds with financial and utilization analysis.
- Strong healthcare data experience and demonstrated understanding of the health delivery system.
- Comprehensive understanding of reporting concepts, database management, and financial concepts extremely helpful.
- Advanced knowledge and 5-7 years proven experience with database/reporting tools (BRIO, Crystal, Hyperion, Access Development, Excel, Tableau, Looker, Cognos, DB2, Ultraedit, etc).
- Advanced knowledge and 5-7 years hands-on experience with data mining, analysis, Informatics data processing software and languages including SAS/SQL/TOAD/MS Access or other capabilities needed to research, explore, analyze (including root cause analysis), and report on Healthcare data; skilled in writing/understanding/manipulating SAS PL and SQL to extract data, and understand end-to-end delivery within a reporting environment.
- In-depth understanding of solution domain related to ad hoc requests, operational and performance reporting, data extracts and data views on reoccurring basis.
- Proven experience in interpreting and translating business needs into technical requirements.
- Demonstrated experience in software development and development lifecycle methodologies; familiarity with or training in agile methodology.
- Strong experience with database concepts and applications, dimensional database design, and quantitative & analytical skills.
- Demonstrated experience in informatics & data exchange, particularly using healthcare and clinical data.
- Demonstrated knowledge and/or experience with HEDIS, VBA coding, microsoft.net , C# and Tableau preferred.
- Demonstrated leadership competencies with the ability to collaborate with others, establish working relationships, and communicate effectively across the organization and at different levels.
- Demonstrated experience in facilitation, leadership and training with intent to effectively organize/present information and coordinate new business solutions for various audiences.
- Highly skilled with navigating and creating professional documents in Microsoft tools such as Excel, PowerPoint, Word, OneNote.
- BS or BA degree in MIS, Business, Computer Science or equivalent mastery and training.
- Experience with continuous quality improvement methods and tools (e.g., statistical process control, Six Sigma, etc.).
- Strong project management skills and comfort in ability to create and achieve success by negotiating and problem-solving in complex organizations / highly matrix management environments.
US Candidates Only: Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, gender identity, disability, veteran status. If you require a special accommodation, please visit our Careers website or contact us at SeeYourself@cigna.com.
Primary Location: United States-Connecticut-Bloomfield
Other Locations: United States-All Cigna Office Locations, United States-Work From Home Jobs
Work Locations: CT 900 Cottage Grove Road
900 Cottage Grove Road Wilde
Job: Bus Ops--Operations Mgmt (Bus)
Work at home opportunity (External):Yes
Shift: Day Job
Employee Status: Regular
Job Type: Standard
Job Level: Individual Contributor
Job Posting: May 8, 2017, 7:54:30 PM
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