Encounter Data Quality Manager

Job Summary

This position is eligible for telework for applicants who reside in Minnesota or in a bordering state, with supervisory approval and satisfactory performance. If you live in a state bordering Minnesota, you must live within 50 miles or less from the primary work location to be eligible for telework.

This position is responsible for overseeing DHS’ collection of encounter data as needed for supporting health care policy, financing, quality and analytic functions, and as required under CMS regulations.  This position also leads on behalf of all of the Healthcare Administration, data governance and alignment initiatives that are part of the various enterprise-level system modernization projects.

This position is responsible for developing, streamlining and implementing administrative data collection mechanisms, implementing data auditing and validation strategies, and developing and maintaining documentation processes to ensure that all of DHS has complete and accurate data on the health care services provided through our public programs for the managed care business. Improving the accuracy, completeness, timeliness and consistency of managed care and other purchasing entities’ data is a critical building block for payment reform. This position will be responsible for ensuring that DHS has adequate data resources to develop, implement and evaluate new payment reforms. It is anticipated that there will be a greater demand for connections between health data being exchanged through electronic health records and administrative encounter data. This position is responsible for identifying and developing opportunities to connect these related activities.

In addition, this position, along with reporting staff, will provide oversight of the various enterprise-level system data modernization projects on behalf of the Healthcare Administration (HCA) divisions. The activities of this manager and staff will ensure that the interests and needs of all activities (processes, policy and informational) of the HCA are properly served in the design, testing and implementation of the many modernization efforts.

Qualifications

Minimum Qualifications

Demonstrated leadership experience*

*Leadership experience can include:

• Experience as a supervisor, leadworker, team lead, project lead;
• Completion of a State of Minnesota leadership program (e.g. ELI, L4);
• A paid/unpaid position leading a program or chairing a committee (e.g. ERG) – experience must include:
• 1+ year of experience identifying issues, goals and strategic actions
• 100+ hours per year time commitment 

AND

Five (5) years of specialized professional work experience in health care quality measurement that demonstrates the following:

• Knowledge of health care claims or encounter data processes 
• Data warehouse use as well as building and using large and complex data sets for analysis analyzing data and/or providing health care industry information 
• Expertise with Minnesota’s provider industry, provider enrollment, claims payment processing and services used by Medicaid Program enrolled providers
• Knowledge of Minnesota’s Medicaid fee-for-service, managed care health and Accountable Care Organization (ACO) care delivery systems, payment mechanisms and costs or other government funding streams.

Preferred Qualifications

• Masters degree in above fields (health care administration, data sciences, etc.)
• Experience with:
• Data Analtyic Modernization projects;
• Integration of encounter, administrative and other types of health data (survey, clinical)
• Perspective of health care policy and its connection to technical systems;
• Production of technical documents, law and rules, agency policies, bulletins, legislative reports and systems requests
• Variety of experiences working effectively with others from different backgrounds and cultures.