Hennepin County

Role Description Hennepin Health (HH) is seeking a System Analytics Supervisor to join their team. In this position, you will be providing training and direction to HH managed care Electronic Data Interchange (EDI), Enrollment, Coordination of Benefits (COB), Third Party Liability (TPL), and Subrogation (Subro) employees. You will also develop program goals and objectives and lead staff in providing daily monitoring of Department of Human Services (DHS) HH operations file processing, Enrollment activities, and COB, TPL, and Subro processing. This position will act as a liaison between healthcare business areas, Information Technology (IT) technical team, vendors, and trading partners, as well as serve as backup for external EDI, enrollment, COB, TPL, and Subro related committees and workgroups. Location and Hours - This position is remote. Remote workers may be required to come on-site 0 to 12 days a year for work meetings, trainings, or for any other reasons that their manager may deem necessary (may include additional days for onboarding and new employee training). - Work hours are typically Monday through Friday, between 8 a.m. to 4:30 p.m., with flexibility. - Based on business needs of this position, hires must live in or relocate to Minnesota. About the Position Type - This is a full-time benefit earning position. You must be a current regular or probationary employee. - This position is internally classified as an Administrative Assistant, Principal. Responsibilities - Provide training, goals, and direction to EDI, Enrollment, COB, TPL, and Subro employees. - Assign and check in on the progress of work, and at completion, document and provide progress reports to management. - Monitor employee performance and execute performance reviews. - Act as a program point of contact and operations subject matter expert (SME) and/or manage complex time sensitive benefits and technical projects to completion and resolution of EDI, Enrollment, COB, TPL, and Subro issues. - Document and implement complex Medicaid benefit and business requirements. - Create and update program policies and procedures. - Perform vendor and member data audits to validate contractual compliance and accuracy of data exchanged with the vendors and provide program approvals. - Monitor electronic claim submission and file reconciliation process with provider and clearing houses. - Lead business acceptance testing of files and interfaces to ensure accurate results. - Act as a program manager and SME for proposal and Request for Proposal (RFP) preparation. - Prepare program budgets and monitor related revenue and expenditures. Qualifications - One of the following: - Bachelor's degree or higher in business administration or other field appropriate to the position and five or more years of experience related to the position. - Nine or more years of experience in general administrative work related to the management of departmental/organizational operations or in a specialty area appropriate to the position. Nice to Have - Experience with technical Medicaid managed healthcare. - Experience in IT in the Medicaid managed healthcare payer field. - Experience in a supervisory role within a healthcare setting. - Experience reading and mapping Healthcare EDI transactions including but not limited to ANSII ASC X12 file standards with emphasis on the healthcare related 837P, 837I, 835 and 834 transaction sets. - Experience interpreting policies, procedures, laws, and regulations. - Experience coordinating departmental budgets and monitoring expenditures and revenue. - Experience with computer applications. Knowledge - Administrative principles and practices relating to the management of departmental operations. - The application of laws and regulations. Ability - Establish and maintain effective working relationships within and outside the organization. - Plan, organize, and lead complex projects to scope, timeline, and budget in the healthcare payer and/or financial industry. - Write complex reports and provide analytical conclusions of critical data. - Investigate and resolve complaints. - Develop and/or maintain program requirements and specification documents. - Communicate clearly and concisely both verbally and in writing. Company Description Hennepin Health provides health care coverage to Hennepin County residents who are enrolled in a Minnesota Health Care Program. Hennepin Health is a nonprofit, state-certified health maintenance organization that contracts with the Minnesota Department of Human Services. We envision being a leader in partnering with our members and communities to improve health, by integrating health care and service to enhance the health and well being of our members and the community.

Role Description Hennepin County's Human Services and Public Health (HSPH) IT admin division is seeking an EPIC Community Connect Analyst/Builder to join the team. In this position, you will work directly with our practices and providers as well as with Hennepin Health system IT staff. We are looking for a candidate that has healthcare domain knowledge, strong problem-solving skills, technical aptitude, and the ability to communicate effectively with stakeholders at all levels. - Configure, maintain, and troubleshoot EPIC modules and related applications. - Manage user security and access controls in compliance with HIPAA and organizational policies. - Assist with system implementations, upgrades, and integration projects. - Collaborate with clinical and administrative teams to analyze workflows and recommend improvements. - Develop and maintain technical documentation, including configuration guides and training materials. - Provide Tier 2 support for EPIC-related issues and escalate as needed. - Participate in cross-functional meetings to align hospital and county IT strategies. Qualifications - One of the following: - Seven or more years of information technology experience. - An approved information technology certificate and five or more years of information technology experience. - Completion of five college/vocational/technical information technology courses and five or more years of information technology experience. - Completion of an approved Hennepin County IT internship and five or more years of information technology experience. - Associate/vocational/technical information technology degree and five or more years of experience. - Bachelor's degree in information technology or a related field and two or more years of information technology experience. - Master's degree or higher in information technology and one or more years of information technology experience. Requirements - EPIC certification in one or more modules. - Experience with EPIC applications in a healthcare setting or other ambulatory EHRs. - Experience with healthcare data integration reporting tools. - Knowledge of EPIC modules, workflows, and security administration. - Knowledge of HL7 interfaces and interoperability standards. - Ability to provide confidentiality and compliance with healthcare regulations. - Ability to manage multiple priorities in a fast-paced environment. - Demonstrate strong interpersonal and collaboration skills to collaborate with diverse teams. - Demonstrate advanced analytical and problem-solving skills. - Effective verbal and written communication skills to communicate with stakeholders at all levels. Benefits - Competitive pay. - Work-life balance. - A variety of benefits and opportunities to grow.

Hennepin Health (HH) is seeking an Operational Business Analyst to join their Claim Requirement and Audit team to work within a Health Plan. This team is accountable for researching complex claim related issues, developing claim requirements, executing text plans, and auditing claims. Conduct research and root cause analysis on various claims to identify and resolve problem payment and configuration concerns. Review, research, and respond to the claim related routes received from the delegated claims vendor and other internal HH departments. Solicit and document claim related business requirements for new benefit, DHS, and regulatory changes. Audit and test complex benefit claim payments to prevent incorrect payments and ensure compliance. Develop test cases and complete business user acceptance testing. Facilitate communication between the delegated vendor and internal business departments to follow up and close action items. Collaborate with the delegated vendor to develop interim claim processing workarounds. Monitor claims related to manual workarounds; retire workarounds when solutions are implemented. Support claims related audit functions such as research claims outcomes, validate claims processed according to HH product business rules and DHS regulatory requirements and work closely with account management, internal audit, and across HH to document audit findings.