Senior Data Analyst

hace 2 semanas


San Juan, San Juan, Puerto Rico abarca health A tiempo completo

Job Summary

Abarca Health is seeking a Senior Data Analyst to support our compliance program effectiveness through data analysis and risk identification. The ideal candidate will possess strong organizational, technical, and data visualization skills, with a strong understanding of industry processes and PBM operations.

Key Responsibilities

  • Execute departmental reports at the required frequency with implemented quality check workflows.
  • Analyze and review data on a regular basis to ensure compliance and consistency.
  • Communicate data outliers to business owners, leadership, and Government Programs management.
  • Work with business areas to discuss identified changes in regulation, define required actions, and ensure requirements are implemented as appropriate.
  • Perform data analysis and validation to ensure required accuracy and specifications.
  • Participate in the Regulatory Change Management Committee meetings, presenting regulatory updates and engaging participation of subject matter experts.
  • Prepare compliance updates and summaries of regulatory requirements identifying required actions, for internal and external stakeholders and maintaining updated Abarca's regulatory log.
  • Lead conversations with clients around regulatory requirements and any impact to the organization, including any potential audit concerns.
  • Support in the development/update of regulatory compliance policies and procedures as well as training materials aligned with government regulations.
  • Support HIPAA investigations, specifically review and keep track of applicable federal and state requirements, including State Medicaid requirements and Client Business Associate Agreements.

Requirements

  • Bachelor's degree in business, healthcare, or related field (In lieu of a degree, equivalent relevant work experience may be considered).
  • 5+ years' experience in healthcare compliance and/or regulatory role.
  • Strong understanding of industry processes, PBM Operations and Medicaid regulations.
  • Excellent oral and written communication skills.

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