Programmer Analyst

DUTIES:

- Support the development and maintenance of business critical applications.
- Responsible for development and integration of business reporting solutions using SQL, Oracle and Crystal.
- Accountable for project deliverables, strong understanding of system analysis methodologies, object-oriented analysis and design.
- Maintain an up-to-date knowledge of national and state-wide codes sets, standards, and regulations pertaining to the handling of claims documents.
- Assist Supervisors within the claims department in identifying, remediating, and resolving issues interfering with the accurate and timely adjudication of claims.
- Play an active role in identifying business requirements and workflow associated with technology initiatives.
- Demonstrate leadership and interpersonal communication skills by working collaboratively and effectively with peers, superiors, and subordinates to accomplish objectives.

SKILLS:

EDUCATION:

- Bachelor's degree in Computer Science or equivalent experience required.

EXPERIENCE & QUALIFICATIONS:

- At least 5 years experience working with healthcare data in a report development role, 10 years experience preferred.
- Must have at least 5 years direct experience developing reports derived from a SQL or Oracle database.
- A minimum of 5 years experience in a healthcare setting, preferably in a setting involving significant interaction with claims and/or encounter data.
- Prior experience working with health plan eligibility files including handling of retroactive eligibility is desirable.
- Must have solid understanding of software development methodologies and be able to assess appropriate methodologies for the work assigned to the unit.
- Familiarity with medical terminology and knowledge of claims billing practices including an understanding of claims data structures is desired.
- Must be familiar with coordinating benefits between health plan payers.
- Must have excellent communication skills, strong analytical and coaching/mentoring skills, team building skills and the ability to work effectively with diverse team members.
- Must have the ability to perform extensive root cause analysis of problem areas and recommend alternative solutions.
- Must be able to work in an environment where critical time constraints exist.
- Experience in development and implementation of reporting solutions for business applications across SQL and Oracle environments required.
- Understanding of how to write applications using Oracle's Application Server and/or other application Servers.
- Experience in writing business driven applications in a Managed Care/HMO environment.