Payer Data Steward III
Company: Oak Street Health
Title: Payer Data Steward III
Location: Treehouse (officially); remote (functionally)
Oak Street Health believes everyone deserves great healthcare – the kind you’d want for your own family. We specialize in providing exceptional care for older adults on Medicare, often in underserved communities where there is little or no quality healthcare.
Oak Street Health is on a mission to rebuild healthcare as it should be with an innovative care model that centers on wellness-based, positive health outcomes for patients, not the volume of services provided. Our unwavering commitment to keeping patients healthy is highlighted by dedicated care teams that take time to get to know each individual, providing the personalized care they need to stay healthy and live life more fully.
We’re an organization on the move! Our rapidly growing national network of primary care centers is staffed by a diverse team of outstanding care providers, service team members, technologists, community outreach experts, business professionals, and more. For more information, visit http://www.oakstreethealth.com.
As Oak Street Health continues to grow, there is an increased need to more efficiently process new payers’ incoming data as well as manage issue resolution arising from legacy relationships. Under the supervision of team management, the stewards assess and quantify the data quality sent by health plans as well as reporting out receipt, cadence and completeness to multiple Oak Street audiences. Files range across eight subject domains: membership/eligibility, authorizations and referrals, medical claims, pharmacy claims, the MMR, the MOR, the MAO-004, and quality gaps (HEDIS/STARS) files. The level of domain experience present will determine what level of steward role a potential candidate will be hired into. The higher the role level equates both to more experience and mastery of multiple domain sets. As such, there are career paths available for those seeking to learn how an innovative provider group mobilizes health plan data for patient care delivery as well as roles for those to leverage their in-depth payer data knowledge in a new arena.
Identify, analyze, and interpret trends or patterns in complex datasets commonly produced by health plans; expectations for incoming domain knowledge at time of hire:
Analyst III - Knowledge of and multiple years’ experience working with health plan membership/eligibility, medical and pharmacy claims, and financial reconciliation; special consideration will be given the candidates who have experience with either prior authorization or HEDIS data
Contribute to the development and sustainment of Oak Street’s payer data quality digital infrastructure
Automate payer data processes, where possible
Function as organizational SME as to the limits of both content and structure of payer data, especially the growth regions of legacy payer relationships
Aid Oak Street’s overall data quality and governance in conjunction with standards developed by Oak Street IT
Partner with operational analytic teams to execute data cleansing strategies to aid the use of payer data to support Oak Street’s mission
Other duties as assigned
What are we looking for?
Bachelor’s Degree and 1-5 years of experience in a healthcare role; both years of experience and demonstrated skill sets will help determine which level of analyst a candidate should be hired into
Preference will be given to candidates with healthcare data experience, whether in IT or as an embedded technology SME in operations
Previous experience working with large healthcare claims and/or EHR databases and their content favored
Applicants with an appropriate combination of education and experience will also be considered
Programming/development experience with MS SQL Server 2014 or newer
Programming experience with Automation Anywhere
Advanced experience with Microsoft Excel or other spreadsheet software
Healthcare informatics, analytics, and reporting knowledge
Data warehousing and/or IT project experience
Experience working with large data sets; common extracts will often include millions of data lines
Someone willing to make 2-4 trips annually to the Treehouse (Oak Street’s corporate headquarters) for face-to-face meetings
Working knowledge of healthcare concepts and their relationships with corresponding data (operations, membership, and finance)
Familiarity with healthcare data and data analytic platforms
Ability to prioritize and manage concurrent projects
Strong organizational skills
Execute work with exceptional attention to detail on all project tasks
Ability to work independently and within a diverse team environment
Strong verbal and written communication skills
Ability to prioritize tasks with little supervision and work under time pressure
Ability to be a team player in a matrix environment
Client consulting experience, especially end-user education of analysts and decision makers at all levels of the organization
US work authorization
Someone who embodies being “Oaky”
What does being “Oaky” look like?
Radiating positive energy
Assuming good intentions
Creating an unmatched patient experience
Driving clinical excellence
Taking ownership and delivering results
Why Oak Street?
Oak Street Health offers our coworkers the opportunity to be at the forefront of a revolution in healthcare, as well as:
Collaborative and energetic culture
Fast-paced and innovative environment
Competitive benefits including paid vacation and sick time, generous 401K match with immediate vesting, and health benefits
Oak Street Health is an equal opportunity employer. We embrace diversity and encourage all interested readers to apply to oakstreethealth.com/careers.