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AI Summary

The role involves designing and developing ETL and BI solutions for clinical supplemental data while managing data governance and acquisition efforts. The architect will collaborate with stakeholders to ensure data accuracy and alignment with quality measurement standards like HEDIS and CMS.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Role Overview

The EA Data Engineering Architect position will serve as a subject matter expert and manage all levels of supplemental clinical data for purposes of quality measurement including Healthcare Effectiveness Data and Information Set (HEDIS), STARS, CMS Adult and Child Core Set, and state-required measure sets or custom measures. This position is responsible for delivering business intelligence solutions by building data models, writing ETL processes, and administering systems to facilitate business intelligence tools. This individual works closely with end users and IT development staff to ensure that new and existing data models and databases are consistent with approved data architecture standards.

Work Arrangement

  • Remote role
  • Monday through Friday, 8:30 AM EST to 5:00 PM EST

 

Responsibilities

  •  Design, develop, and test enhancements to ETL and BI solutions focusing on clinical supplemental data.
  • Act as key point of contact with internal and external stakeholders for supplemental data aggregators, health information exchanges, vendors, and provider-direct sources.
  •  Partner with Information Services (IS) and key business stakeholders to align and manage an active Data Governance agenda where data is manipulated to yield actionable information for the purpose of evidence-based decision making.
  • Lead data acquisition efforts across the organization with the main focus of aligning Provider Network Management, Business Sourcing, and IS business functions to ensure contracts and data are accurately aligned.
  • Work with complex Data modeling and design patterns for BI/Analytics reporting requirements.
  • Lead ETL design and development initiatives including data analysis, source-target mapping, data profiling, change data capture, ETL coding, QA testing, and performance tuning.
  • Support technical development in designing, testing and implementing databases and data lake changes.
  • Collaborate with organization and department leadership in defining and modifying the supplemental data strategy through analysis of existing and potential sources to determine true impact, ROI, and areas of opportunity.
  • Participate in automation script code reviews and provide guidance on their compliance with automation best practices
  • Demonstrate skills using code repositories.
  • Identify interdependencies, ambiguities or omissions and make suggestions to improve requirements and ensure usability/testability
  • Learn rapidly and enthusiastically, focusing on understanding the application/product/area in detail.
  •   Perform other duties as assigned by Management.

Education and Experience 

  • Bachelor’s Degree in Computer Science or related field
  • Minimum of 3 years of working with data mapping, scrubbing, quality assurance, and submission of clinical supplemental data
  •  Minimum of 3 years in interpreting, analyzing, and providing recommendations regarding data accuracy and data collection needs and processes
  • Minimum of 3 years with SQL, Azure, Python, Tableau, Power BI or similar
  • Minimum of 3 years with quality measure (HEDIS, CMS, STARS, NQF, and/or AHRQ) technical specifications
  • Minimum of 3 years working with HEDIS platform software or similar preferred, DQM a plus
  • Minimum of 3 years in health plan or major group/facility in similar data role
  • Experience in an automation of reporting environment; agile environment, report automation engineering
     

Skills

  • Experience working with clinical data specific to CCD, EMR/EHR/HIE data sources.
  • Experience with process improvement, workflow, benchmarking and / or evaluation of business processes\
  • Experience with provider relations 
  • Working knowledge of National Interoperability and Clinical Data Exchange standards including HL7, CCD/CCD-A, FHIR and traditional EDI 
  • Familiarity with HEDIS and other quality measure technical specifications
  • Background in clinical quality management
  • Excellent verbal and written communication skills; outstanding interpersonal skills; the ability to relate positively with individuals at all levels both internally and externall
  • Proven ability to effectively communicate complex data and performance metrics to various audiences, including senior leadership
     

    Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

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