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ADMINISTRATIVE OFFICER III

Data Partner Specialist

Recruitment #17-002247-0057

GRADE

15

LOCATION OF POSITION

750 E. Pratt St., Baltimore, 21202

Main Purpose of Job

The Partner Data Specialist is responsible for performing analytic review of partner carrier/qualified plan data being submitted to the Maryland Health Benefit Exchange (MHBE). This person will assess and review partner carrier data submissions, including, but not limited to, Plan Benefit and Rate Data, Network Adequacy/Provider Data, and other inputs as required by the Affordable Care Act and Exchange initiatives. The Partner Data Specialist will present findings to the Manager of Plan Services, and other relevant parties. The Partner Data Specialist duties will affect critical Exchange functions such as: plan certification, plan shopping data verification, plan and benefit data reporting, carrier monitoring, and other data-driven functions.

POSITION DUTIES

The incumbent in this position will perform the following:

Work with carrier plan data to ensure that plans and rates displayed on Maryland Health Connection match the benefits and rates that have been approved by the Maryland Insurance Administration;

·  Work/troubleshoot with carriers and MHBE technical contractors to reconcile plan and benefit data displayed on Maryland Health Connection with approved rate and form data

·  Gain expertise in the business rules of the Maryland Health Connection Plan Shopping Module

· Track and report on reconciliation progress to Plan and Partner Management

· Manage and track upload into the Plan Management module

· Use industry standard plan management portals for administration of the plan certification program (e.g. SERFF)

Perform reviews and analysis on carrier data submissions

· Provide reports on queries of carrier benefit designs, rates, and provider directory/networks

· Create and manage a MHBE Plan and Rate Database

· Use enrollment data to analyze market trends and consumer preferences

· Assist with initiatives on data-driven Network Adequacy Standards

Assist the MHBE Compliance Officer and Manager of Plan Services with data-driven compliance and audit initiatives.

Continued education on policy and plan certification standards with respect to Federal guidance and carrier data

· Continued monitoring of RegTAP and other CMS publication sources for relevant guidance as it pertains to carrier plans, plan data, and network adequacy metrics

· Attend the annual CMS Plan Certification Conference with the Manager of Plan Services

· Provide summation papers to the Manager of Plan Services on selected publications

Develop reports, publications, and data visualizations with Manager of Plan Services

· With the Manager of Plan Services develop publications, leveraging the data collected by MHBE, for state and public audiences

Assist the Manager of Plan Services with various projects as assigned, including but not limited to:

· Attending meetings, offsite with MHBE staff

· Representing the unit in absence of leadership at meetings

· Deliver presentations to state and public audiences

MINIMUM QUALIFICATIONS

Education: Possession of a Bachelor's degree from an accredited four-year college or university.

Experience: Three years experience in administrative or professional work.

Notes:

1. Candidates may substitute additional experience in administrative staff or professional work on a year-for-year basis for the required education.

 2. Candidates may substitute additional graduate level education at an accredited college or university at the rate of 30 semester credit hours for each year of the required experience.

3. Candidates may substitute U.S. Armed Forces military service experience as a commissioned or non-commissioned officer involving staff work that included the regular use of independent judgment and analysis in applying and interpreting complex administrative plans, policies, rules or regulations or analysis of operational programs or procedures with recommendations for improvement on a year-for-year basis for the required education and experience.  

DESIRED OR PREFERRED QUALIFICATIONS

1.  A masters degree in Health Policy, Public Health or Biostatistics in a healthcare setting is preferred.

2.  Experience in the insurance industry performing in: Plan Services, Benefits or Compliance.

3. Experience in utilizing software tools for data analysis (ex. Excel, R, Stata, etc.).

4. Experience in analyzing health care data.

5. Experience or relevant coursework in health care policy/health data analysis.

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Employees in this classification may be assigned duties which require the operation of a motor vehicle. Employees assigned such duties will be required to possess a motor vehicle operator’s license valid in the State of Maryland.

EXAMINATION PROCESS

Applicants who meet the minimum qualifications will be evaluated.  The evaluation will be a rating of your application based on your education, training and experience as they relate to the requirements of the position.  Therefore, it is essential that you provide complete and accurate information on your application.  Please report all related education, experience, dates and hours of work.  For education obtained outside the U.S., a copy of the equivalent American education as determined by a foreign credential evaluation service must accompany the application.  All information concerning your qualifications must be submitted by the closing date.  We will not consider information submitted after this date.  Applicants certified to list will be placed in the Best Qualified, Better Qualified, or Qualified category and receive eligibility for a period of one (1) year.  Eligibility may be extended beyond one (1) year period.

BENEFITS

FURTHER INSTRUCTIONS

The online application process is STRONGLY preferred, if the online process is not available to you, you may complete and submit a completed paper application to:

Shadrick Phillips

Office of Human Resources

Maryland Health Benefit Exchange

750 East Pratt St., 16th Floor

Baltimore, Maryland 21202  

If you have questions concerning this recruitment, please email: shadrick.phillips1@maryland.gov.

TTY Users: call via Maryland Relay at 1-800-735-2258

We thank our Veterans for their service to our country, and encourage them to apply.

As an equal opportunity employer, Maryland is committed to recruiting, retaining and promoting employees who are reflective of the State’s diversity.