Senior SystemsResearch Analyst
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Job Location:
Oklahoma City, OK - USA
Monthly Salary:
Not Disclosed
Posted on:
3 days ago
Vacancies:
1 Vacancy
Job Summary
Job Posting Title
Senior Systems/Research AnalystAgency
807 HEALTH CARE AUTHORITYSupervisory Organization
Program Integrity & AccountJob Posting End Date
Refer to the date listed at the top of this posting if available. Continuous if date is blank.
Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Estimated Appointment End Date (Continuous if Blank)
Full/Part-Time
Full timeJob Type
RegularCompensation
$60886.00 / annualWhy Youll Love Working Here
At the Oklahoma Health Care Authority (OHCA) your work matters. Every day our team helps ensure Oklahomans have access to better health and better care. Guided by our core values Passion for Purpose Trust & Transparency Empowerment & Accountability Best-in-Class Outcome-Driven and Servant Leadership we foster a workplace where people feel supported respected and empowered to make an impact. Learn more about OHCA.
Lets Talk Benefits
We know your great work deserves great support. Heres a snapshot of what we offer for all eligible employees.
Generous state-paid benefit allowance to offset insurance premiums.
A wide selection of insurance plans with no pre-existing condition exclusions.
Flexible Spending Accounts for health care and dependent care.
11 paid holidays annually.
15 days of vacation and 15 days of sick leave in the first year.
Longevity Bonus recognizing years of public service.
Public Service Loan Forgiveness eligibility and tuition reimbursement.
Wellness benefits including an on-site gym and fitness center discounts.
Job Description
Location: 4345 N Lincoln Blvd Oklahoma City OK 73105
Salary: $60886.00 / annual
Work Schedule: Monday Friday
Primary Hours: 8:00 a.m. 5:00 p.m.
Agency/Division Information
The Oklahoma Health Care Authority (OHCA)works to ensure Oklahomans have access to better health and better care.The agencys core values include passion for purpose trust and transparencyempowermentand accountability best in class and outcome-driven and servant leadership.As part of the interview process candidates maybe requiredto attend an in-person interview at our Oklahoma City office.
Position Purpose
The purpose of this position is to support the integrity and effective operation of the Medicaid Management Information System (MMIS) bymaintainingand monitoring reference file subsystems and ensuring alignment with OHCA policy as well as state and federal Medicaid regulations. This role analyzes healthcare coding structures and payment rules evaluates system impacts of policy and regulatory changes and collaborates with medical policy finance provider engagement and claims units to ensureaccurateclaims processing and program compliance. The position also conducts research performs operational andutilizationanalysis supports system modifications and special projects and provides guidance and training to internal staff and external partners to promote consistent interpretation and implementation of Medicaid program policies.
PrincipalActivitiesMay Include:
Maintains the OHCAOKMMISreferencefilesubsystemwhichincludes: ICD-/CM and PCS diagnosis and surgical procedure codesCPTrevenueand that all files reflectappropriate rulesincluded in OHCA policy as well asappropriate stateand federal policies.
Using multiple methods ofoversightmonitorsthe integrity of the reference file (e.g. report generation and review of associated documentation).
Researches and investigatesspecial areasof with OHCA Medical Professional Finance and Policy units toreviewslaw and regulations andmakesrecommendations for changes to the Medicaid program.
Interfaces with OCHA staff regardingOKMMIS issueschangesproblemsor frequent evaluations ofOKMMIS issues and provides problem solvingassistanceto ensure that the payment mechanisms of OHCAcomply withOHCA policy and all state and federal regulations.
Interfaces with OHCAProviderEngagementand Claims Adjudication policy andassistin problem training concerning new and changing programs.
Researches and investigatesspecial areasof law and regulations and makes recommendations for changes to the Medicaid program.
Performs a variety of routine analytical tasks and special projects related to operational andutilizationperformanceand/or analysisfor the Medicaid program.
Coordinatesin the completion of special projects/studies including report generationreviewand detailed recommendations.
Coordinate with agency staff and fiscal agent staff to assureappropriate outcomesare met bymonitoringinter-agency information system changes and modifications for project developmentimplementationand deadlines.
Provides trainingassistanceto other agencies providersclientsand agency staff with interpretation of existing policies development of new policies andclaimsprocessing issues.
RepresentsOHCA at meetingstrainings task forces or conferences.
Other duties as assigned.
Knowledge Skills Abilities and Competency Requirements
This position requires knowledge of Medicaid program operations healthcare claims processing and medical coding systems including ICD CPT HCPCS and revenue codes as well as an understanding of state and federal healthcare regulations that govern Medicaid reimbursement. The role requires strong analytical skills tomonitorand maintain system reference files evaluate claims payment logic interpret policy requirements andidentifyoperational or compliance issues within the MMIS environment. The ability to research regulations analyze system impacts coordinate with internal units and external partners and communicate complex policy or system changes clearly to stakeholders is essential. Success in this role also requires strong organizational skills attention to detail and the ability to manage multiple analytical tasks and projects while supporting program integrity and operational improvements. Key Korn Ferry competencies aligned with this work include Manages Complexity Collaborates and Ensures Accountability reflecting the need to navigate regulatory requirementsworkeffectively across technical and policy teams andmaintainaccurate compliant system operations.
**To be considered for this position your application must include a resume/CV with complete work and education history.**
Education and/or Experience:
Bachelors degreein public health health information management or closely related field and two years of professional experiencein healthcare data analytics healthcare information systems and/or healthcare program operationsOR
An equivalent combination of education and experience.
Preference Qualifications Include:
Experience in health care procedures medical coding or medical claim paymentsand processing
Medicaidpolicy interpretation or program complianceexperience
Healthcare data analysisreportingorutilizationreview
Physical Demands andWork Environment
Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels.In the course ofperforming job duties employeesare required tospeak stand walk and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.
Accommodation Statement
The Oklahoma Health Care Authoritycomplies withapplicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race color sex religion disability age national origin or genetic information. Ifa reasonableaccommodation is needed toparticipatein the job application or interview process to perform essential job functions and/or to receive other benefits and privileges of employment please contact the Civil Rights Coordinator at .
Notice to applicants:
Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.
Current State of Oklahoma employees must apply for open positions internally through WorkdayJobs Hub.
Equal Opportunity Employment
The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information race religion color sex age national origin or disability.
Current active State of Oklahoma employees must apply for open positions internally through the Workday Jobs Hub.
If you are needing any extra assistance or have any questions relating to a job you have applied for please click the link below and find the agency for which you applied for additional information:
Required Experience:
Senior IC
