Healthcare Data Quality Analyst

Clearance Level
IT Quality Assurance
West Des Moines, Iowa

REQ#: RQ132688

Travel Required: Less than 10%
Requisition Type: Regular

GDIT is looking for an experienced Healthcare IT data Quality Analyst to support the Trusted Third Party ( TTP)  Program.

In this role, you will participate in data validation, data quality review and approval of data deliveries.  You will also be on the front line of partner management for the Data Management team and provide partner feedback and deliver claims data in support of the Trusted third Party mission of Fraud Waste and Abuse in support of Center for Medicare and Medicaid Services(CMS) Center for Program Integrity (CPI) fighting Fraud Waste and Abuse.

•    Reviews and evaluates software products and systems to ensure adherence to company and customer quality standards. Develops software/systems testing procedures and conducts tests
•    Design, code, test, debug, document, and implement changes to new and existing solutions
•    Perform unit testing of code to assure the delivery of a product that meets the user's specifications
•    Provides technical advice to technical leads, assisting them with high level planning and cost justifications
•    Review healthcare claims for accuracy, completeness and overall quality
•    Develop and maintain quality review routines and processes to automate standard reviews
•    Troubleshoot claims quality issues for new and existing partners, making recommendations and providing feedback to eliminate ambiguity
•    Leads project efforts, ensuring project requirements and timelines are met
•    Work with the end user analysts developing the requirements of the Data Warehouse solution
•    Collaborate, Lead and mentor internal colleagues
•    Develop processes to validate data by designing test cases
•    Manage and oversee the technical aspect of the partner data and workflow, ensuring all partner data is tended to in a timely manner
•    Engage partners directly in coordinating their onboarding, providing a feedback loop on data suitability
•    Work with other GDIT program resources responsible for Partner Liaision engagement, keeping the continuity from initial onboarding through the transition to Operations and Maintenance
•    Participate in daily standups for Agile development, manage tasks in Jira and artifacts in Confluence
•    Participate in continuous process improvement with an eye toward higher quality data and streamlining of partner onboarding, ensuring a positive partner experience

•    Healthcare Claims processing knowledge for multiple payers’ healthcare claims data, such as two or more of the following: Medicare Fee-For-Service, Medicare Advantage plans, state Medicaid programs, and/or private commercial payers.
•    Knowledge on the difference between claim header and detail records
•    An thorough understanding of the differences between institutional and professional benefit types and how they relate and differ from Pharmacy claims
•    Experience with various methods to identify members of a healthcare payer, SSN, Member id, birth date, gender etc.
•    Experience with various provider types and how they relate to specialties and taxonomies
•    Understanding of data needs required to support a fraud waste and abuse program
•    Experience working as a member of a Scrum development team
•    Proficiency in query language such as SQL (coding or, at a minimum, graphical user interface)

Preferred experience:
•    BA/BS, 10+ years experience
•    SAS Enterprise Guide or similar tool, understanding of data structures and formats

Attributes for Success:
•    Interest in continual learning in application development and emerging technologies
•    Strong communication skills, a strong team player; able to accept and deliver ambiguous tasks
•    Self-starter with the ability to contribute unsolicited ideas with the team for continuous improvement
•    An individual who takes ownership and accountability of their work and processes
•    Somebody who looks for innovation throughout processes

•    Ability to thrive in dynamic, fast-paced, fun environment
•    Must be able to work closely with all project stakeholders
•    A demonstrated ability to learn and acquire new technologies as needed
•    Excellent customer services skills with respect to planning and conducting client-facing technical discussions

The likely salary range for this position is $100,000 - $150,000, this is not, however, a guarantee of compensation or salary; rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

View information about benefits and our total rewards program.

About Our Work

We are GDIT. The people supporting some of the most complex government, defense, and intelligence projects across the country. We deliver. Bringing the expertise needed to understand and advance critical missions. We transform. Shifting the ways clients invest in, integrate, and innovate technology solutions. We ensure today is safe and tomorrow is smarter. We are there. On the ground, beside our clients, in the lab, and everywhere in between. Offering the technology transformations, strategy, and mission services needed to get the job done.

COVID-19 Vaccination

GDIT does not have a vaccination mandate applicable to all employees. To protect the health and safety of its employees and to comply with customer requirements, however, GDIT may require employees in certain positions to be fully vaccinated against COVID-19. Vaccination requirements will depend on the status of the federal contractor mandate and customer site requirements.

GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.