[Hiring] Regulatory Reporting Specialist - Technical @Amerihealth Caritas

Role Description

The Regulatory Reporting Technical Specialist is responsible for providing technical expertise to the department by identifying, developing, and implementing systematic solutions that improve the efficiency of regulatory reporting processes while maintaining high standards of accuracy, data integrity, and timeliness.

Work Arrangement: Remote within the United States, working Eastern Standard Time.

Responsibilities:

• Leads the development, management, and implementation of multiple projects ranging from small initiatives to complex efforts. Coordinates project phases, resources, requirements, and deliverables.
• Serves as a technical lead within the department, providing technical expertise, training, and guidance to departmental management and staff.
• Develops and maintains comprehensive knowledge of data sources used for regulatory reporting, including, but not limited to, the Data Warehouse, Facets, JIVA, FEI, and the Reports Database.
• Designs, develops, manages, and implements customized, user-friendly technical solutions that automate complex reporting requirements across multiple lines of business. Uses relational databases and other reporting tools to improve the efficiency, consistency, and accuracy of report completion.
• Creates and maintains detailed documentation of reporting processes and technical solutions, including explanations of underlying programming logic and clear instructions to support the transition of solutions to end users.
• Collaborates with end users and department management to develop and implement appropriate testing procedures for technical solutions. Performs benchmarking, validation, and reconciliation analyses to ensure the accuracy and integrity of reported data.
• Coordinates solution development across all project phases, including coding, data, resource, and business requirements. Works effectively with users, developers, internal departments, and external contacts as appropriate.
• Identifies and evaluates opportunities to improve reporting quality, efficiency, and processes. Conducts analysis and research and communicates recommendations to appropriate decision-makers.
• Provides recommendations and participates in operational decision-making related to systems, reporting tools, processes, and procedures used to support data integrity and reporting efficiency.
• Identifies and analyzes data and reporting anomalies; researches, tests, and validates results; and provides clear explanations for identified variances and changes. Documents agreed-upon explanations in formal notes to file and communicates them to Regulatory Reporting management.

Qualifications

• Bachelor’s Degree or equivalent experience required.
• 6 years of experience in Information Services, Reporting, Claims, Managed Care, or Healthcare environment required.
• Proficiency in Microsoft Access, Excel, Word and Relational Database Design, SQL, and SSRS.
• Basic knowledge of Databrick, POWER BI and VBA programming, highly preferred.
• Thorough understanding of business computer programs, applications, and systems, database structures, and data files required.
• Ability to train staff in all aspects of Regulatory Reporting and to provide continued updates as policies and procedures change.
• Complete understanding of reporting or data analysis processes.
• Strong communication (both written and verbal), analytical, and problem-solving skills.
• Strong organizational skills with the ability to coordinate several projects simultaneously.
• General understanding of claims processing, clinical coding, and basic business practices.
• Ability to appropriately extract and manipulate data from a variety of sources and databases.

Benefits

• Flexible work solutions including remote options, hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for you and your dependents on Day 1.
• 401(k).
• Tuition reimbursement and more.