Manager, Health Data Operations

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.

Under the general supervision of the Director of Health Data Operations, the Manager, Health Data Operations is responsible for assuring that BILHPN’s Provider, Payer, and Referral data is accurate and reportable. Manager, Health Data Operations is responsible for also assuring that BILHPN’s Provider, Payer, and Referral Data is reported correctly based on contractual guidelines and integrated correctly in the population health vendor tool(s). Confirms data is accurate for those responsible for reporting on healthcare trends, contract performance, clinical performance, and intervention programs. Maintains and supports the BILHPN Provider Enrollment database, MD Staff, which will be used for reporting any and all provider data internally and externally. Defines roles and responsibilities related to data governance and ensures clear accountability for stewardship of the company’s principal data by creating policies and procedures that can be implemented throughout BILHPN. Is central in building the relationship between BILHPN Data Stewards, Analysts, and Vendors to establish and govern an enterprise data governance implementation roadmap. Works with vendors, internal and external resources to resolve system-based data issues and contractual requests. Understands data complexity and can translate data requirements among these parties. Serves as a liaison between the external constituencies and BILHPN leadership. Assists the BILHPN Data Steward and Data Analysts in developing solutions to analyze the populations' most pressing needs with the use of best practices for coding to make these processes more efficient. Serves as a data representative in IT, population health, and contracting meetings to ensure that all the data warehouse needs are supported and understood by the organization. Makes sure the BILHPN Data Stewards and Data Analysts have access to the appropriate data documentation. Utilizes technology to best support decision making within the organization. The Manager, Health Data Operations oversees the management of incoming payer data and ensures the payer data gets sent to the appropriate parties. The Manager, Health Data Operations functions as the Subject Matter Expert (SME) on the specified data application(s) and serves as a support contact for the BILHPN Data Analysts and Data Stewards. Assures the integrity of data. Works directly with payers, data vendor(s), BILH IT to solve any data related issues and makes appropriate recommendations to provide clean and up to date data. This position is responsible for a full range of activities which ensure the operational effectiveness and excellence of all the BILHPN data warehouses.

Job Description:

Essential Duties & Responsibilities including but not limited to:

1. Builds relationships and works directly with data vendor(s) to ensure data integration, accuracy, and data integrity. 2. Serves as a liaison between the BILHPN Leadership, BILHPN Staff, and internal and external vendors. 3. Maintains and supports the BILHPN Provider Enrollment database, MD Staff which will be used for reporting any and all provider data. 4. Works closely with BILHPN’s Provider Enrollment Team to ensure the team is accurately documenting provider data, within the system. 5. Works closely with BILHPN’s Provider Enrollment Team to ensure the team is completing the Data Quality Checks, sent by Health Data Operations team on a routine schedule, to ensure the data integrity within MD Staff. 6. Implements policies and guidelines for data management and data quality. 7. Develops standard operating procedures for data handling and archiving. 8. Collaborates with other players to improve the effectiveness of the database tools and services. 9. Communicates with BILHPN Leadership and Data Analysts about any data related topics.

10. Documents and maintains all fields and files coming in and out of BILHPN related to the Payers. 11. Responsible for the overall success of data testing, including results verification and monthly publish/freeze sign-offs. 12. Manages specific application quality assurance and activities including the tracking of issue reports and change requests and ensuring their timely resolution. 13. Serves as a provider/risk data custodian and attends data vendor(s)’meetings. 14. Assures proper data documentation exists, is up to date and available to share with others on a periodic basis. 15. Manages the data projects list and assures BILHPN Leaderships agreement with the prioritization. 16. Conducts project prioritization meetings. 17. Develops solutions to create automated file load and reporting. 18. Supports ACO processes and performs tasks related to ACO data requirements (e.g. RPO). 19. Serves as a data representative in IT, population health and contracting meetings to ensure that the