Please contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Monu Karwasara at email address ...@generistek.com can be reached on # 630-###-####.
We have Contract role Business Systems Consultant Remote for our Salem OR. Please let me know if you or any of your friends would be interested in this position.
Position Details:
Business Systems Consultant Remote-Salem OR
Location : Remote 100%
Project Duration : 10+ Month
Job Summary:
The Office of Information Services (OIS) is a shared service provider for the Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS). OIS provides the technology systems and services that support more than 18,000 OHA and ODHS agency staff at local offices and facilities around the Client. These systems and services help the two agencies determine client service program eligibility; provide medical, housing, food, and job assistance; provide addiction, mental health, vocational and rehabilitative services; protect children, seniors and people with physical and/or developmental disabilities; process claims and benefits; manage provider licensing and Client facilities; and promote and protect the Client health.
OIS/ OHA are seeking an experienced Business Systems Consultant with expertise in data system analysis and evaluation and advanced communication skills to provide project management support, data system evaluation and improvement support, including the documentation of improvement recommendations, business and technical requirements and test cases, and delivery of testing support in accordance with business, data security and regulatory requirements.
Background and scope of project:
HAL is a Medicaid analytical and reporting SQL database solution and environment managed by the MADI (Medicaid Analytics and Data Integration) Unit housed within the Office of Health Information Technology and Analytics Infrastructure that exists within the Health Policy and Analytics (HPA) Division of the Oregon Health Authority (OHA).
Medicaid administrative data is primarily made up of 1) medical claims submitted by health providers and Coordinated Care Organizations (CCOs) to receive payment for health services delivered to patients enrolled in Oregon's Medicaid program, which is known as the Oregon Health Plan (OHP) and 2) Medicaid enrollment data from the OHA/ ODHS ONE eligibility system. The raw transactional data are stored in Oregon's Medicaid Management & Information System (MMIS). HA analysts typically access these data through a MMIS data warehouse solution called Decision Support and Surveillance Utilization Review System (DSSURS), or in the Health Analytics Library (HAL), where the raw Medicaid enrollment and utilization/ claim data are packaged differently into easier to analyze categories and groups for analysis. These analytical value-added elements are not present in DSSURS.
HAL contains Medicaid enrolment and claims data that is accessed by two main sets of users:
- OHA's Office of Actuarial and Financial Analysis (OAFA) team users, who use the data for setting of per-capita rates of reimbursement of health care services provided by Coordinated Care Organization (CCO's) to Oregon's Medicaid population, and various other financial analyses.
- Office of Health Analytics' reporting teams, who access Medicaid enrollment and claims data for the development of different enrollment and utilization analytical and data visualization products.
The HPA MADI unit wants to launch a HAL modernization project to analyze, identify and make improvements to the HAL analysis and reporting database solution. This project has the following objectives:
- nalyzing the existing HAL database solution and environment, identifying any refinements or rework to HAL architecture, dataflows, governance or management processes, and developing a roadmap for HAL future state.
- Reprogramming HAL ETL code, currently written in legacy SAS language, into SQL language, to prepare HAL for migrating to the OHA ODE (Oregon Data Environment) cloud Azure environment (NOTE: The migration to the cloud, expected to occur in the next 1-2 years, is out of scope for this project and will require working with OIS and other OHA teams)
- Gathering and documenting requirements, developing and testing other improvements to the HAL data logic, including:
o Updating claim data grouping categories used predominantly by the Office of Actuarial and Financial Analysis (OAFA) team for rate capitation analyses, to reflect updates Medicaid national coding standards.
o Performing other coding improvements needed by OAFA team users and other HAL users to improve analytical value and capabilities of HAL data or reflect changes in Medicaid eligibility, program, beneficiary and claim administrative coding- these types of improvements have accumulated over time and have reached a point in which they require a focused project and dedicated resources.
Tasks:
Contractor's Key Person shall work with various OHA program areas and business teams and OIS staff as needed performing the following tasks: