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Manager, Data Validation & Audit

Company: Accident Fund Holdings, Inc
Location: Southfield
Posted on: February 16, 2020

Job Description:

Responsible for managing and coordinating day-to-day office operations and workflow of data validation and audit staff in support of the company's Risk Adjustment and Quality departments. Manage, motivate and develop technical analytical staff. Exchange information with staff and offer assistance in addressing workflow needs. Manage all resources associated with the data validation and audit operations unit including performing advanced level analysis, managing department workload and priorities, maintaining efficient processes, and communicating results. Aid department director in strategic planning. RESPONSIBILITIES/TASKS: Analyzes data and presents data validation and audit analysis in support of the company's Risk Adjustment department. Effectively communicates, makes recommendations, and presents data to appropriate personnel. Works with various business units to help create and drive strategic plans and metrics. Acts as a liaison to IT and assists in planning of future improvements to Advantasure systems. Monitors data validation and audit progress of various Advantasure platforms, makes recommendations to take corrective action as necessary, and monitors action plans. Works with the Risk Management team on identifying and monitoring risks. Provide guidance, training and leadership to employees and mentor other analysts. Assure appropriate level of documentation in regards to data validation and audit department and procedures. Regularly communicate issues or progress to department director. Adhere to deadlines; ensure work is completed on a timely basis. Participate in development of annual departmental budget. Subject matter expert for communication used for the Advantasure leadership team. Ensure that all material produced is of utmost quality, is internally consistent, and is completed in timely manner. Institute a peer review process for critical deliverables and provide peer review support for other processes as requested. Work with stakeholders to identify, create, and monitor various reports and key business metrics. Also provide guidance to end-users regarding use and interpretation of results. Assist stakeholders in deploying strategies. Performs ad-hoc projects, research, and analysis in support of key stakeholders. Drives business decisions via effective communication and superb understanding of problems presented, analytical assumptions and solutions, and resources required to achieve desired results. Ensure efficient and effective use of company resources, evaluate processes and procedures, and develop new procedures. Exercise discretion when communicating outside of department. Maintain confidentiality of information processed as appropriate. This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. Bachelor's degree in computer science, mathematics, finance, economics, business, or related field is required. Master's degree is a plus. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged. EXPERIENCE: With proper education, seven years analytics experience is required, eight preferred. A minimum of three years demonstrated leadership in business computer and data systems environment required. Two years management or supervisory experience, or combinations of related training and experience strongly preferred. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: Extensive knowledge and expertise of risk adjustment business and principles, both for Medicare Advantage and ACA business. Ability to apply the principles of logical thinking to define problem; collect data, establish facts and draw conclusions. Ability to learn new software easily. Ability to manage multiple priorities, establish work flows and meet necessary deadlines. Thorough knowledge of departmental procedures and workflows. Demonstrated leadership abilities. Ability to comprehend the consequences of various problem situations and address them. Ability to make competent, independent decisions. Ability to maintain confidentiality as appropriate. Ability to perform other assignments at locations outside the office. Ability to meet necessary deadlines. Superior analytical skills. Demonstrated skills in a variety of database platforms, business intelligence and analysis tools. Mastery of Microsoft Office products. WORKING CONDITIONS: Work is performed in an office setting with no unusual hazards. Some travel required. The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

Keywords: Accident Fund Holdings, Inc, Southfield , Manager, Data Validation & Audit, Accounting, Auditing , Southfield, Michigan

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