Dir, Reporting & Analytics - Databricks/SQL/Power BI - Remote

Dir, Reporting & Analytics - Databricks/SQL/Power BI - Remote

30 Mar 2025
Ohio, Cleveland, 44101 Cleveland USA

Dir, Reporting & Analytics - Databricks/SQL/Power BI - Remote

Job DescriptionJob SummaryCollects, validates, analyzes, and organizes data into meaningful reports for management decision making as well as designing, developing, testing and deploying reports to provider networks and other end users for operational and strategic analysis.Knowledge/Skills/AbilitiesThe Director of Reporting & Analytics is a key leader within the organization. This person is empowered to advise senior management and other departments on reporting and analytics strategies in support of various business initiatives.The position's essential functions are as follows: Works with senior executives, Vice Presidents and AVPs across the enterprise to determine reporting and analysis needs Manages functional departments. Mentors, coaches, and provides guidance regarding financial reporting and analysis Sets goals and plans of reporting and analysis business units in alignment with the operating plan, budget, and regulatory requirements Sets direction of reporting design, nomenclature, approach, requirements gathering, end-user communications protocols, release schedules and change management process Sets direction of reporting quality assurance process to minimize end-user error identification Sets direction of report change management process Sets up process and direction to report score risk areas prospectively in timely and concise manner Ultimately responsible for quality assurance for all reports generated by staff reporting to this position Functions as subject matter expert on finance and analytics topics. Able to teach financial/technical information Escalates gaps in projects to VP and senior management when identified Implements strategies to ensure service level benchmarks for report turn-around are met. Demonstrates best practices and collaboration on projects.Job QualificationsRequired EducationBachelor's degree in IT or Analytics field or equivalent experienceRequired Experience Minimum 3 years management experience Minimum of 3 years experience in Reporting and Analytics Minimum of 1 year experience in Health Care IndustryPreferred EducationClinical degree or advanced IT degree or advanced public health or health care administration degree preferredTo all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.Pay Range: $107,028 - $250,446 / ANNUALActual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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  • Description A Brief Overview The Professional Fee Clinical Documentation Specialist (CDS) will serve as an advisor and expert resource for providers to improve the accuracy of clinical documentation to support patient complexity, risk profiles and appropriate E/M levels thereby supporting the provider\'s efforts and their professional fee billing. The CDS primarily assist providers in identifying clinically relevant information and capturing the clinical documentation needed to accurately reflect patient acuity. The Professional Fee CDS will focus on the recapture and identification of chronic conditions reflected in Hierarchical Condition Categories (HCCs), which directly impact the patient risk adjusted profile (RAF score) calculated by the associated risk plans. They will also assist with highlighting opportunities based on the provider\'s medical decision making to appropriately reflect the level of service provided for patient care.The Professional Fee CDS will be responsible for completing pre-visit and post-claim reviews as well as providing clear communication and education to providers on their documentation, coding and billing practices, in adherence to compliance standards set by governing entities such as CMS, AHA, etc.Pre-visit reviews are intended to identify documentation opportunities for the provider to recapture previously documented HCCs diagnoses, or new suspect conditions not previously captured that are identified by the CDS\'s comprehensive chart reviews. These efforts assist in establishing accurate risk profiles and related health care costsPost-claim reviews focus on E/M encounters and highlight opportunities based on a provider\'s medical decision making and the patient\'s acuity to support appropriate and accurate E/M level assignments as well as any HCCs identifiedThe Professional Fee CDS will also coordinate with colleagues from the CDI Program or other members of the organization regarding education and training geared towards improving clinical documentation based on findings from pre-visit and post-claim reviews What You Will Do Coordination with Professional Fee CDI Program leadership and colleagues. Fosters teamwork and utilizes strong team building measures Performs pre-visit chart reviews to assist in highlighting relevant documentation and diagnoses in compliance with governing policies and industry guidelines. Applies a \"clinical detective\" mindset to identify new HCC diagnosis capture opportunities based on appropriate clinical indicators for the patient. Also performs post-claim reviews focused on appropriate E/M level assignments and any opportunities related to level of service and HCCs. Uses performance and outcome data from third-party support or other sources to identify high priority providers Creates specialty-specific education on relevant topics as identified in data analytics and from clinical encounter reviews and post-claim education chart reviews Develops and maintains a systematic education schedule and approach for providers in the hospital and clinic/office setting including but not limited to complete documentation, appropriate diagnosis code selection, E/M level assignments and updates to coding guidelines. Delivers ongoing feedback and education to communicate importance of complete documentation and key concepts during regular clinic or provider meetings or on individual basis, as needed Upholds working knowledge and stays current on latest CMS and industry guidelines, with specific understanding of HCCs and implications for documentation Maintains strict confidentiality of all patients, employee and physician information according to HIPAA guidelines Additional Responsibilities Shares in organization\'s vision, demonstrates its values, supports its philosophy and is sensitive to its mission. Demonstrates knowledge of and follows departmental and hospital policies and physician office procedures S

Job Details

  • ID
    JC53743645
  • State
  • City
  • Full-time
  • Salary
    N/A
  • Hiring Company
    Molina Healthcare
  • Date
    2025-03-30
  • Deadline
    2025-05-29
  • Category

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