Analyst, Membership

The Analyst, Membership works with the Central Decision Support Systems (DSS) staff and customers to transform financial and administrative data into relevant information for operational, tactical and strategic decision making. This position will ensure the accuracy and timely operations of the membership interfaces between the Common Membership (CM) system and DSS and between DSS and the National Pricing System (NPS) for the six Kaiser Permanente regions outside of California (Georgia, Ohio, Mid-Atlantic, Northwest, Hawaii and Ohio).Major Responsibilities: Ensures the timely extract and transformation of membership data between CM and DSS and DSS and NPS. Monitors automated interfaces to ensure timely completion and ensure validation and problem resolution occurs so that data is delivered on time and according to specifications.Performs and develops on-going and ad-hoc validation of source and destination data. Verifies the accuracy of data against source, over time and between membership, benefits, claims, group, division and risk score subject areas. Prepares and distributes reports that monitor the accuracy of data transmitted between CM, DSS and NPS. Identifies and notifies customers and team members of data anomalies. Understands source business processes, systems and data and consults with regional and national customers to ensure these processes support regional and national pricing, under-writing, actuarial and business development needs. Manages look-up tables required to transform membership data from source CM data to DSS and NPS. Regularly monitors source data for the presence of new codes in source data and works with regional and national customers and team members to transform these values. Prepares ad-hoc analyses necessary to support projects, change requests and development of new functionality in NPS and DSS. Participates in other DSS and NPS activities as requested.Minimum Requirements: BA or BS in business, health care or related field.Training in skills necessary to access, analyze and report on large data sets stored in Oracle databases. Membership accounting or health plan (pricing, actuarial, under-writing, business development) operations, financial and operational analysis and/or a proven ability to access and analyze data stored in relational databases. Highly skilled in the use of tools to access large data sets stored in Oracle databases. This may include skills with any type of SQL (PL-SQL, T-SQL, etc). Membership accounting and/or health plan operations. Knowledge of the KP Common Membership system preferred but not required.Financial and operational analysis. Relational database concepts. Required Competencies: The Analyst, Membership is expected to be knowledgeable in membership and familiar with claims, benefits and risk score subject areas. Relevant experience should include knowledge of software to support accessing (PL-SQL, T-SQL, Toad, etc) and analyzing (Excel, SAS, etc) large data sets stored in Oracle relational databases. We are looking for individuals who are highly motivated, enjoy working in teams and are critical-thinkers that can analyze complex problems. In addition, you must have a history of providing exceptional customer service and have excellent written and oral communication skills. Highly skilled in tools used to analyze large data sets (Excel, SAS, SPSS, etc). Moderately skilled or familiar with tools used to report on large data sets (Crystal, Business Objects, Cognos, Access). Exposure to administrative healthcare coding schemes including CPT, HCPC, DRG, ICD9, NDC. Exposure to UB and HCFA 1500 and other common administrative forms used in healthcare.This position consistently supports compliance and the Principles of Responsibility (Kaiser Permanentes Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licensure requirements (if applicable), and Kaiser Permanentes policies and procedures.Visit our Website at www.kp.org/jobs and create a personal profile. Please use the Copy and Paste option to attach an unformatted (text only) resume. Kaiser Permanente offers exceptional benefits. A competitive compensation package will be offered to applicants, commensurate with experience. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer.INTERNAL EMPLOYEES: Please use the Kaiser Permanente Employees link to create your profile. Use the Copy and Paste option to attach an unformatted (text only) resume. Program Offices does not require any Transfer Applications or Performance Appraisals at this time. However, you will be notified if your appraisal will be needed at a later date. Additional Information Reference Code: 917072 Position Type: Full Time