Specialist, Data Compliance - Indiana

This role ensures all Healthy Indiana Plan (HIP) and Hoosier Healthwise (HHW) data conforms to Indiana Family & Social Services Administration (FSSA) and Office of Medicaid Policy & Planning (OMPP) data standards and policies.

Responsibilities

• Ensure all HIP and HHW data conforms to FSSA and OMPP data standards and policies.
• Manage data quality, change management, and data exchanges with FSSA, OMPP, or its designees.
• Oversee data quality and verification, data delivery, change management processes for data extract corrections and modifications, and enforcement of data standards and policies for data exchanges.
• Coordinate with the State and Indiana Market to implement data exchange requirements.
• Ensure HIPAA and regulatory compliance rules are addressed for all data movement.
• Drive ETL standards and practices to establish and follow data quality standards set forth by FSSA and OMPP.
• Work with business areas and IT to ensure integrity and proper integration for all sources of enterprise data.
• Prioritize team activities based on Data Management team priorities and bandwidth.
• Collaborate with areas connected to the Enterprise Data Warehouse to ensure reporting, business intelligence, and analytic data needs are met.
• Assist in data analytics of regulatory compliance activities, including audit and monitoring results, regulatory complaints, and grievances.
• Lead analysis of new and changed regulatory requirements to identify downstream impacts and system, people, and process opportunities impacting the Indiana market.
• Perform other job-related duties as requested.

Requirements

• Bachelor’s degree required; equivalent years of relevant work experience may be accepted in lieu of required education.
• Three (3) years of experience managing data quality and data exchange processes, including data integration and data verification.
• Healthcare experience required.
• Experience in data management functions in a multi-faceted environment preferred.

Skills

• Knowledgeable in healthcare data and healthcare data exchange standards.
• ETL architecture and design.
• SQL Server knowledge required.
• Metadata solutions or tool experience preferred.
• Strong written and verbal communication skills.
• Knowledge of managed care preferred.
• Knowledge of healthcare data coding such as CPT-4, HCPCS, ICD-9, DRG, and Revenue Codes a plus.
• Ability to work independently and within a team environment.
• Critical listening and thinking skills.
• Decision-making and problem-solving skills.
• Training and teaching skills.
• Indiana Medicaid knowledge preferred.

Pay

$72,200.00 - $115,500.00 annual salary. CareSource considers a combination of education, training, experience, scope and complexity of the role, discretion and latitude required, and other external and internal data when establishing salary. In addition to base compensation, you may qualify for a bonus tied to company and individual performance.

Benefits

CareSource offers a substantial and comprehensive total rewards package focused on every employee’s total well-being.

Schedule

• Work from home; may require attending meetings in the office.
• Occasional travel up to 15%.