Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 40 years, MetroPlusHealth has been committed to building strong relationships with its members and providers.

Position Overview

The position of Data Engineer in the Analytics and Reporting Department is responsible in managing encounter data submission to NYSDOH, CMS and other regulatory entities as required. The responsibility includes troubleshooting EDI mapping issues, Encounter data reporting errors, monitoring Encounter Data Quality reports, ensuring adherence to EDI standards, writing complex SQL Queries and stored procedures, SSIS jobs for EDI file submission, and troubleshooting EDI error records. Additionally, this role is responsible for developing and maintaining EDI documentation including process flow and cross-functional team collaboration regarding identification of EDI problem areas. Lastly, the Data Engineer is responsible for preparing test data, conditions and expected results to verify new EDI updates and logic.

The successful candidate must have strong SQL programming skills, EDI Analytical skills, communication skills, and healthcare experience with knowledge in membership, provider, and claims data.

Work Shifts

9:00 A.M – 5:00 P.M

Duties & Responsibilities

Monitor and submit Encounter Data files to NYSDOH OSDS and CMS.
Collaborate with vendors/end users on correcting EDI error transactions and resubmissions to NYSDOH and CMS.
Automate manual processes for Encounter Data submissions.
Support the Compliance and Regulatory department for any inquiry on Encounter Data processes.
Support MMCOR reporting
Create KPI reports on Encounter Data reporting.
Create SQL stored procedures and flow diagrams and document the process for Encounter Data Reporting.
Troubleshoot EDI Errors and keep track of all the resubmissions.

Minimum Qualifications

Bachelor’s degree in Information Systems, Computer Science, Database Management, or related field.
Minimum 5 years of programming experience in SQL Server database object development including but not limited to stored procedures, functions, views, SSIS and SSRS, X12 EDI mapping and development, and troubleshooting EDI errors.
Minimum 3 years’ experience in complex healthcare data like Claims and Enrollment.
Working knowledge of EDI X12 Standards
Previous experience in BI reporting tools, such as BusinessObjects, Tableau, or Power BI
Knowledge of Visual Studio, .Net Development, XML, BizTalk

Integrity and Trust
Collaboration and Time management skills
Functional/Technical skills
Written/Oral Communication
Ability to work effectively in a team environment and adapt to different projects and assignments quickly.
Excellent analytical and problem-solving skills

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MetroPlusHealth

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