Network Management Analyst

Network Management Analyst

Regular

Non-Exempt

GENERAL DESCRIPTION:

Responsible for collecting, evaluating, and maintaining crucial data for the daily company Census. Accountable for analysis, ensuring data quality, collaborating with hospitals, and supporting user testing processes for implementing new technologies to enhance efficiency in the unit and organization. This role requires a proactive and analytical individual capable of ensuring the company's data integrity, contributing to standards compliance, and participating in strategic initiatives.

ESSENTIAL FUNCTIONS:

• Assess all hospitals, rehab, and skilled nursing facilities daily reports and determine the inclusion of cases in the daily Census using specific criteria as required by the HEDIS (Healthcare Effectiveness Data and Information Set) measures TRC (Transitions of Care) & FMC (Follow-Up After Emergency Department Visit for People with High-Risk Multiple Chronic Conditions).
• Generates and analyzes data reported by hospitals, rehab, and skilled nursing facilities to ensure an updated Census and reduce prolonged stays.
• Verify and audit Census Reports to identify necessary updates to ensure data integrity. As well, as rectify erroneous data and ensure information quality.
• Identify and rectify risk situations in intrahospital and emergency room census data. Refer all risk situations to the Specialist to ensure that action plans are taken to prevent further issues.
• Daily audits of the SFTP (Secure File Transfer Protocol) Retention, Discharge_Summary, Assertus_SDL and Assertus CCD (Continuity of Care Document) to ensure discharge summary files are successfully uploaded to the system on time.
• Audit Discharge Summary and CCD images with errors, rectify findings, and ensure successful uploads.
• Analyze, document, and keep facilities and ancillary demographic information up to date. The analyst refers to all identified demographic information that needs to be updated on the system, such as PMHS. This ensures all the provider's information is up to date for internal and external directory purposes.
• Collaborate in coordinating meetings with hospitals to meet HEDIS TRC and FMC standards and requirements.
• Identify patterns in the electronic transmission data to maintain the company Census database integrity. As well, refer all risk situations to the Integration and Interoperability Lead to ensure that action plans are taken in place to prevent any further issues.
• Analyze data reported by the delegated entity FHC (First Healthcare) to ensure an updated Mental Health Census and reduce prolonged stays.
• Collaborate on user testing processes during the implementation of new technologies.
• Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
• May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS:

Education and Experience: Associate's Degree or at least 60-64 college credits. At least one (1) year of experience in the Healthcare Industry, preferably in the Clinical record-keeping and documentation area.

Proven experience may be replaced by previously established requirements.

Certifications / Licenses: Not required.

Other: Knowledge of programs such as PMHS, True Care, Secure Document Loader, and Provinet. Proficiency in managing Protected Health Information (PHI).

Languages:

Spanish Intermediate (comprehensive, writing and verbal)

English Intermediate (comprehensive, writing and verbal)

We are an Equal Employment Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities.