Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

• Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY: 

This position will play a key role in developing and maintaining the necessary reporting tools for monitoring of provider, member, claims, care management and utilization management data.  This position will help lead process improvement activities within the Analytics team to support health plan operations. A qualified candidate will exhibit strong familiarity with using data from various relational databases.  Candidate must exhibit a strong aptitude for analytical thinking and must possess demonstrated data skills.

MINIMUM QUALIFICATIONS:

 

  1. Education/Specialized Training/Licensure:
    • Bachelor's Degree required
    • Advanced Degree preferred
  2. Work Experience (Years and Area):
    • 3 years' experience with SQL query writing.
    • 3 years' experience with reporting tools (e.g., MS Excel, Access, SQL Reporting Services, Power BI or similar, etc.)
    • Knowledge of healthcare coding (ICD, CPT, DRG).
    • Must have experience developing actionable reporting using key metrics communicated in an easy to understand manner.
       

Work Schedule:  Flexible     

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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