Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. Job Description Job Summary: Responsible for producing reports from various sources to provide the department /division with actionable information or business intelligence. Working with marginal oversight, the incumbent is responsible for performing complex research, analysis, and reporting of network utilization, cost containment and key operational information. This is a senior level position. Responsibilities: · Evaluate data and report findings for accuracy, completeness, intent, and scope, etc. · Determine or agree upon deliverables with customer, as well as determining the resources necessary to meet those deliverables · Act as liaison with IT /vendor and customer and initiate /implement project plan for requests · Perform appropriate analysis on data: forecasting, modeling, regression · Mine data from appropriate system and perform appropriate analysis on data · Present data and provide feedback to client/customer; making recommendations where appropriate · Provides guidance and day-to-day oversight of reconciliation functions to support Monthly Membership Reports, Medicare Secondary Payer and Coordination of Benefits · Challenge the status quo and propose improvements in processes for higher efficiency and effectiveness · Accountable for the financial reconciliation and vendor reconciliations for assigned lines of business · Establish, monitor, and enforce reconciliation policies and procedures and internal controls · Accountable for researching existing and new legislative changes in federal and statutory requirements · Develop relationships with subject matter experts (SME) · Seek and adopt best practices in data reporting · Perform other relevant tasks as assigned by management Education/Experience: · Bachelor degree or equivalent years of work experience is required · Minimum of five (5) years of business operations or similar experience is required, preferably in a health care environment · Looking for someone with NJ Medicaid exp, claims processing exp and data exp. · This is not a heavy data position. SQL exp is good, SAS would be a plus , but not required. Knowledge: · Prefer five (5) years data reporting experience · Understanding interdependencies among data Travel (If Applicable): · Some travel may be required. Qualifications Education/Experience: · Bachelor degree is required · Minimum of five (5) years of business operations or similar experience is required, preferably in a health care environment · Looking for someone with NJ Medicaid exp, claims processing exp and data exp. · This is not a heavy data position. SQL exp is good, SAS would be a plus , but not required. #J-18808-Ljbffr