Download VIII. Internal/External Contacts

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PP Muskie School Department: Cutler Institute, Disability and Aging
Organizational Relationships:
Reports to: Senior Computer & Database Specialist
Supervises: Supervises work of Computer and Data Specialist I and Research
Assistant as appropriate
Coordinates with: Project staff and other Institute professionals. Gathers data and
information from representatives of contracting agencies.
Statement of the Job:
The primary purpose of this position is to provide highly technical computer and database
management support to project teams working with health care data with a focus on Medicaid
claims and eligibility data. This position requires extensive knowledge of Health Care data
(i.e., Medicaid and Medicare) and how the data is processed thru a claims processing system.
The Health Data Programmer /Analyst must have a thorough understanding of the policies that
impact this data and how changes to the policy will impact the analysis. The Health Data
Programmer /Analyst has extensive knowledge of the use of health information to inform
policy, manage the care of program members through quality metrics including HEDIS type
indicators and pay providers including pay for performance. The Health Data Programmer /
Analyst manages data acquisition, analytic and programmatic file construction, programming
standards and documentation. The Health Data Programmer / Data Analyst designs and
develops analytic databases to meet project requirements, manages and assures the quality of
claims and encounter data file construction and data manipulation, provides statistical analysis
as required by a project, and prepares written reports, including description of analytic methods
and interpretation of study results.
Essential Functions:
A. Data Analysis: Maintains a thorough understanding of the claims and eligibility processing
system and policy changes and how this impacts the data. Uses this information to analyze
data via SQL and/or SAS. Provides Research and/or Technical staff with specifics on how
to analyze the data accurately.
B. DBO/Database Developer: Develops and implements strategies for secondary database
development using large Relational Database Management Software (RDBMS) with a
preference for SQLserver. Translates secondary data into Access, SAS and SQLserver
databases. Gathers data from various sources, prepares and processes data for analyses. .
Creates and maintains static and intermediate tables, includes setting indexes, primary keys,
links etc. Manage access/permission of users to tables. Maintain documentation for each
database. Design and create automated end-user reports using various software reporting
tools (e.g., Report Services, Access, Excel).
C. Database Design: Provides assistance to Research and/or Technical staff in database design
based on technical knowledge of field. Collects and organizes data as appropriate; writes
manuals and creates automated databases, using various database packages. Trains and
supervises others in specific data processing and design tasks.
D. Systems design, application development and implementation of Accessand XP applications
utilizing SQL and Visual Basic. Directly involved with end users to ensure system meets
functional needs. Design table structures, forms, queries and reports.
E. Data Archives: Responsible for documentation and archiving research-related data and
programs related to the state and institute health data systems.
F. Contract and Grant Writing: Assists in writing proposals by drafting technical data-related
sections and participating in work plan development.
Marginal Functions:
Supervisory Responsibilities:
Coordinates, supervises and oversees work of Computer and Data Specialist I, Research
Assistants and work-study students as appropriate. Demonstrates knowledge and experience in
maintaining a safe working/learning environment.
Budget Responsibilities:
Public and Professional Activities:
Assists project team in preparing project results for presentation at regional or national
conferences, and in preparing articles for publication, with some supervision.
VIII. Internal/External Contacts:
Knowledge, Skills, and Abilities:
 Demonstrated knowledge and experience in data analysis of large health claims and/or other
health databases.
 Demonstrated knowledge of health care policy and its impact on claims data processing and
 Preference for knowledge and competence in statistical software (including SAS, SPSS, and
spreadsheet programs).
 Preference for knowledge of research design and evaluation.
 Demonstrated experience with SQL using SQL server.
 Demonstrated ability to independently complete assigned tasks.
 Flexibility and ability to handle changing priorities.
 Possess an attitude that fosters a respectful, non-threatening workplace environment.
Master’s degree and at least three years of analytic experience with health care claims and
eligibility data; or a Bachelor’s degree and a minimum of five years of analytic experience with
health care claims and eligibility data
Knowledge of relational database design and analysis techniques using SQL required.
Knowledge of and prior work with health care information (i.e., Medicaid and/or Medicare)
Knowledge of health quality metrics including HEDIS indicators and pay for performance
techniques required.
 Detailed familiarity with aspects of the health care delivery system relevant to claims
processing such as claim forms, use of diagnostic and procedure codes, and other billing
 Experience in client tracking based systems.
 Familiarity with the following Specifications of Systems / Hardware & Software
Programming in Microsoft Access, Visual Basic for applications or other objectoriented programming languages
Microsoft SQLserver,
Microsoft Reporting Services
For Office Use Only
Approved Date:
Job Family:
Salary Band:
Job #:
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