Director of Encounter Data Reporting

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

The position of Director of Encounter Data Reporting in the Analytics and Reporting Department is responsible in managing encounter data submission processes to NYSDOH, CMS, and other regulatory entities as required. The responsibilities include leading the encounter data reporting team in design and development of the data processes, engaging stakeholders, and vendors to ensure encounter submission meeting regulatory requirement, provide support to other business areas and compliance department in all encounter data related inquires and audits, and provide KPI to executives on encounter data reporting.

The successful candidate must have strong project management skills, communication skills, analytical skills, SQL Server programming skills and healthcare experience with knowledge in membership, provider, and claims data.

• Manage overall encounter data submission process to NYSDOH OSDS.
• Manage overall encounter data submission process to CMS.
• In working with vendor management, provide support and oversight to delegated vendors on encounter data submission processes.
• Support compliance and regulatory for any inquiry on encounter data processes.
• Support MMCOR reporting
• Create KPI reports on encounter data reporting.
• Participate in organizational data governance and data strategy activities.
• Create process documents.
• Create policies and procedures for encounter data processes.

• Bachelor’s Degree in information systems, computer science, or database management
• Minimum 7 years of programming experience in SQL Server database development
• Minimum 5 years of experience in progressively complex healthcare data analytics.
• Previously experience in BI reporting tools, such as BusinessObjects, Tableau, or Power BI
• Ability to manage database developers and data analysts.

Professional Competencies

• Integrity and Trust
• Leadership and management skills
• Functional/Technical skills
• Written/Oral Communication
• Teamwork
• Excellent analytical and problem-solving skills
• Excellent verbal and written communication skills.

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