
SENIOR DATA BASE ANALYST
- Tallahassee, FL
- $1,946-2,900 per month
- Permanent
- Full-time
- Participate in rate setting as well as analyses, studies or research projects.
- Perform data analysis, including summarizing, reviewing, verifying, and reconciling data as needed for rate setting and other actuarial unit projects.
- Actively seek to ensure data integrity and accuracy and identify discrepancies.
- Develop cost estimates and assists in financial analysis and budget preparation.
- Create reports under the direction of the supervisor to meet needs both internally and externally.
- Keep electronic documentation on all rate settings and data analysis.
- Participate in developing models that rely on statistical and actuarial analysis such as health care cost impact models, trend, IBNR, forecasting, etc.; verify or change calculation logic when needed, under the direction of the supervisor; participate in model brainstorming; suggest ways to improve model processes; document model revisions and instructions.
- Assist in actuarial reporting including Federal rate filings.
- Facilitate the finalization and implementation of rates.
- Work with other units to ensure all issues impacting rate setting are conveyed to the actuarial vendor.
- Review deliverables for actuarial vendor, other vendors, another agency, or within AHCA for accuracy and consistency.
- Review managed care rates to determine compliance with applicable state and federal laws, rules, and regulations.
- Ensure all deliverable requirements are met.
- Perform other deliverable review duties outlined in office procedures or as assigned.
- Provide technical and analytical support to Agency staff and contracted entities on work related to State Medicaid managed care plans, capitation rates, financial analysis/projections.
- Serve as a subject matter expert on rate setting and actuarial reports.
- Provide assistance in responding to inquiries and external requests related to rate setting and other actuarial services unit projects and tasks.
- Represent AHCA in meetings with outside vendors or contractors.
- Respond to inquiries and explains actuarial methodology to health plans and other appropriate parties, concerning rate setting, providing supporting documentation.
- Participate in peer-review processes.
- Maintain up-to-date knowledge concerning the Florida Medicaid program, including pertinent Federal laws and regulations, state statutes and rules, and the Florida Medicaid State Plan.
- Participated in continuing education of Medicaid and other Agency functions.
- Assist in estimating the impact of legislative changes.
- Review proposed legislation.
- Work on or assist in unit assigned projects.
- Serve on committees and teams.
- Other ad hoc projects as assigned.
- Maintain up-to-date knowledge of the Florida Medicaid data systems, including Florida Medicaid Management Information Systems (FMMIS), Florida Health Care Connections (FX) Enterprise Data Warehouse (EDW), and the SQL server.
- Keeping up-to-date technically and knowing one's own jobs' and related jobs' functions.
- Attend meetings both internally with other units and bureaus within the Agency, as well as externally with health care plans.
- Document, organize and standardize work process, improve file quality and speed up work process whenever possible.
- Keep documentation on noteworthy events, monthly magic, and Agency payments.
- Ensure the accuracy of work assigned through the development and use of reconciliation techniques.
- Facilitate meetings and calls both with the actuarial vendor and other entities; keep track of notes and action items.
- Show initiative and participate in brainstorming ways to improve all processes; propose new ideas to supervisor.
- Participates in strategic planning for Agency goals.
- Follow all unit, bureau, and Agency procedures.
- Perform other duties as assigned.
- State Group Insurance Coverage Options, including health, life, dental, vision, and other supplemental insurance options;
- Flexible Spending Accounts;
- State of Florida retirement options, including employer contributions;
- Generous annual and sick leave benefits;
- 9 paid holidays a year and 1 Personal Holiday each year;
- Career advancement opportunities;
- Tuition waiver for courses offered by Florida’s nationally ranked State University System;
- Training and professional development opportunities;
- And more!
- Experience with Excel.
- Experience with Access, SQL, Python, or other Database programs.
- Experience working with large data sets. Preferably, health care data experience.
- Ability to conduct fact-finding research.
- Ability to collect, evaluate, and analyze data to develop alternative recommendations and solve problems.
- Ability to communicate technical concepts effectively.
- Ability to organize data into logical format for presentation in reports, documents, and other materials.
- Ability to multi-task, work in a fast-paced environment, and follow-through on assignments.
- Ability to work well both independently and with others.
- Ability to establish and maintain effective working relationships with others.
- Ability to organize electronic notes and document processes.
- Knowledge of the methods of data collection and analysis.
- Two years of professional experience utilizing Excel.
- Five years of professional experience utilizing Access, SQL, Python, or other Database programs.
- Preference will be given to candidates with a bachelor's degree or a more advanced degree from an accredited college or university in a relevant discipline such as mathematics, actuarial science, computer science, or statistics.
- Preference will be given to candidates who have actuarial experience in a managed care setting.
- Preference will be given to candidates who have passed three actuarial exams. Three VEE credits may substitute for one exam.