System Analytics Supervisor (Internal Hennepin Health applicants only)

Full Job Description

Hennepin Health (HH) is seeking a System Analytics Supervisor to join their team.

In this position, you will be providing training and direction to HH managed care Electronic Data Interchange (EDI), Enrollment, Coordination of Benefits (COB), Third Party Liability (TPL), and Subrogation (Subro) employees.

You will also develop program goals and objectives and lead staff in providing daily monitoring of Department of Human Services (DHS) HH operations file processing, Enrollment activities, and COB, TPL, and Subro processing.

This position will act as a liaison between healthcare business areas, Information Technology (IT) technical team, vendors, and trading partners, as well as serve as backup for external EDI, enrollment, COB, TPL, and Subro related committees and workgroups.


Click here to view the job classification specification.

• Provide training, goals, and direction to EDI, Enrollment, COB, TPL, and Subro employees.
• Assign and check in on the progress of work, and at completion, document and provide progress reports to management.
• Monitor employee performance and execute performance reviews.
• Act as a program point of contact and operations subject matter expert (SME) and/or manage complex time sensitive benefits and technical projects to completion and resolution of EDI, Enrollment, COB, TPL, and Subro issues between the HH business areas, IT technical staff, and trading partners, and serving as back up for external EDI, Enrollment, COB, TPL, and Subro related committees and workgroups.
• Document and implement complex Medicaid benefit and business requirements.
• Create and update program policies and procedures.
• Perform vendor and member data audits to validate contractual compliance and accuracy of data exchanged with the vendors and provide program approvals.
• Monitor electronic claim submission and file reconciliation process with provider and clearing houses.
• Lead business acceptance testing of files and interfaces to ensure accurate results.
• Act as a program manager and SME for proposal and Request for Proposal (RFP) preparation and act as program stakeholder for proposal vendor selection for department associated contractual relationships.
• Prepare program budgets and monitor related revenue and expenditures.

Need to have:

• One of the following:
  • Bachelor's degree or higher in business administration or other field appropriate to the position and five or more years of experience related to the position.
  • Nine or more years of experience in general administrative work related to the management of departmental/organizational operations or in a specialty area appropriate to the position.

Nice to have:

• Experience:
  • With technical Medicaid managed healthcare.
  • In IT in the Medicaid managed healthcare payer field.
  • In a supervisory role within a healthcare setting.
  • Reading and mapping Healthcare EDI transactions including but not limited to ANSII ASC X12 file standards with emphasis on the healthcare related 837P, 837I, 835 and 834 transaction sets.
  • Interpreting policies, procedures, laws, and regulations.
  • Coordinating departmental budgets and monitoring expenditures and revenue.
  • With computer applications.
• Knowledge of:
  • Administrative principles and practices relating to the management of departmental operations.
  • The application of laws and regulations.
• Ability to:
  • Establish and maintain effective working relationships within and outside the organization.
  • Plan, organize, and lead complex projects to scope, timeline, and budget in the healthcare payer and/or financial industry.
  • Write complex reports and provide analytical conclusions of critical data.
  • Investigate and resolve complaints.
  • Develop and/or maintain program requirements and specification documents.
  • Communicate clearly and concisely both verbally and in writing.

Hennepin Health provides health care coverage to Hennepin County residents who are enrolled in a Minnesota Health Care Program. Hennepin Health is a nonprofit, state-certified health maintenance organization that contracts with the Minnesota Department of Human Services. We envision being a leader in partnering with our members and communities to improve health, by integrating health care and service to enhance the health and well being of our members and the community.

Hennepin is the largest county government organization in Minnesota. Our employees work every day to improve the health, safety and quality of life for our residents and communities.

All of our jobs align with our mission to serve residents through transformative services that eliminate disparities, eliminate inequities, and create opportunity for all and our vision of a community where all people are healthy, all people are valued, and all people thrive.

Our employees receive a combination of competitive benefits and positive workplace culture not found at other organizations.

This includes meaningful work that impacts our community, competitive pay, work-life balance, a variety of benefits and opportunities to grow. Learn more at The Bridge (login as Guest).

Hennepin County envisions an organization where our commitment to diversity and the elimination of disparities is fundamental in providing excellent service to our community. Your future. Made here.

This posting may be used to fill current and future vacancies. Watch this video for application best practices and tips.

Invitations to interview will be based upon an assessment of education and experience. Final candidates will be required to complete a background check.

If you have any questions, please contact:

Taylor Dahlberg

taylor.dahlberg@hennepin.us

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