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analyst iii epic professional billing claims

Community Care Cooperative

<div><p><b>Title: </b>Epic Professional Billing Claims Analyst III<br>
<b>Reports to: </b>Manager of Professional Billing and Claims<br>
<b>Classification: </b>Individual Contributor</p><p><b>
Location: </b>Boston (Hybrid)<br>
<b>Job description revision number and date: </b>V 3.0; 04.14.2025</p><p></p><p><br>
Organization Summary:</p><p>
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices nationally. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.</p><p></p><p><br>
Job Summary:</p><p>
The Professional Billing Claims Analyst III position will be housed under a subsidiary organization of C3, Community Technology Cooperative, LLC (CTC). To implement, maintain, support, and maximize the use of clinical, financial, and administrative portions of the software applications utilized by CTC in conducting daily operations under the direction of the Manager of Professional Billing and Claims.</p><p>
Responsibilities:</p><ul><li>
Maintaining current clinical, financial, and administrative applications, implementing new clinical, financial, and administrative applications</li><li>
Assisting in the assessment of workflow processes and assisting in process re-engineering to achieve efficiencies in departmental operations</li></ul><ul><li>Assisting users in developing reports and analyses, troubleshooting, and resolution of application issues</li><li>Working with the IT Education staff to assist in training users and in the development of documentation</li><li>Maintaining a level of knowledge about IT operations and network issues and maintaining current industry knowledge</li><li>Ability to maintain current system applications</li><li>Facilitate end users&rsquo; ability to understand and maximize the use of the software to perform daily operations</li><li>Evaluate user knowledge and work with IT education staff to develop specialized training when necessary; educate users in system optimization</li><li>Acts as liaison between users and the software vendor(s)</li></ul><p>
Guides the modification of system applications in instances where current applications impede performance or where changes will enhance performance</p><ul><li>Ensure system application updates are working properly before updates are loaded into the live system by coordinating testing and update dates with users and vendors</li><li>Integrate new application(s) in the existing HIS according to the implementation schedule</li><li>Respond to user questions with timely answers and/or referral to appropriate department/person</li><li>Assist users with technical problems by alerting HIS Operations staff to the need for repair or investigation</li><li>Coordinate with Database Analysts to provide expertise in the development of reports and analyses</li><li>Work with other IT staff to ensure interfaces between applications and systems are functioning properly</li><li>Maintain and periodically review dictionaries, assist in entering and maintaining user codes, maintain the security of applications, and ensure consistency between various dictionaries</li><li>Investigate on timely basis discrepancies in statistics which could indicate a problem with the accuracy of data</li></ul><p>
 Work with application managers, staff from affected areas, and representatives from other impacted areas, to analyze computer system functions and compare data and existing systems both functionally and procedurally</p><ul><li>Implement new clinical, financial, and administrative software, including add-on features, and/or new routines in existing applications</li><li>Participates with other IT staff and other clinical, financial, and administrative areas in the planning and implementation stages of the application, including the development of dictionaries</li><li>Work with Department Managers and IT Education staff to ensure training programs for use of applications are developed and conducted for all levels of users and participate in such programs when needed</li><li>Develop system documentation to supplement vendor manuals and which defines processes, procedures, and policies regarding utilization of various functions</li><li>Assist departments with the development of downtime procedures</li><li>Work with Operation Manager and staff to establish schedules for report production and system jobs to maintain balanced system utilization and minimize system degradation, if necessary</li><li>Sustain working knowledge of key functions of all aspects of the department in order to provide emergency coverage in the absence of others in the department</li><li>Work with Applications Manager to accomplish other departmental tasks</li><li>Notify the Applications Manager of requests for custom modifications to standard applications and of any updates to standard systems which replace existing custom modifications so that the Application Manager can take appropriate action</li><li>Assist in the development of IT policies and procedures and notify users as appropriate</li><li>Participate in applications on-call rotation for the information system</li><li>Participate in workgroups and committees as necessary</li><li>Demonstrates competent and effective job performance skills as evidenced by the volume, skill, and technical knowledge of work performed, neatness, accuracy, thoroughness, and completeness, and the ability to follow instructions</li><li>Strong attention to detail</li><li>Ability to manage multiple priorities in an effective and organized manner</li><li>Demonstrates the ability to interact effectively and in a professional manner with peers</li><li>Administration, and other customers as demonstrated by willingness to work with others to achieve CTC&rsquo;s goals</li><li>Ability to present a friendly and positive manner, willingness to seek additional tasks</li><li>Responsibility to assist the department and/or peers, ability to be flexible and perform new tasks and adjust to change even under pressure</li><li>Ability to accomplish results by working effectively with or through other people</li><li>Ability to hear and communicate with others in a clear, understandable, and professional manner in person and on the phone</li><li>Ability and commitment to provide outstanding customer service</li><li>Ability to actively listen, demonstrate patience and empathy, and authentically engage with individuals in a caring and helpful manner</li><li>Ability to identify and resolve problems and maintain composure and sound judgment in difficult or stressful situations</li></ul><p></p><ul><li><br>
Maintain current industry knowledge by attending industry seminars, reviewing professional literature, and communicating on a regular basis with other IT analysts</li><li>Required to travel onsite for site visits and project milestones either at the health center or the CTC office in Boston</li><li>Other duties as assigned</li></ul><p>
Required Skills:</p><ul><li>Ability to understand, analyze, document, and explain business processes and the data that underly them</li><li>Experience working with Electronic Health Records, medical claims, and other health care data</li><li>Experience working with Clearinghouses to facilitate claims transmission</li><li>Subject Matter Expert in claims area of Epic software</li><li>Flexible and adaptable to change in a fast-paced environment</li><li>Demonstrated ability to work both independently and as part of a team</li><li>Demonstrated ability to thrive in a fast-past environment</li><li>Nuanced interpersonal communication skills</li><li>Minimum experience of having participated in at least one Epic implementation</li></ul><p></p><p><br>
Desired Other Skills:</p><ul><li>Familiarity with the MassHealth ACO program</li><li>Familiarity with Federally Qualified Health Centers</li><li>Experience working in a provider organization</li><li>Experience working in a managed care environment</li><li>Experience with anti-racism activities, and/or lived experience with racism is highly preferred</li></ul><p>
Qualifications:</p><ul><li>Bachelor&rsquo;s degree in a healthcare-related field, Information Systems or Business Management</li><li>Resolute Professional Billing Claims Administration (required)</li><li>Resolute Professional Billing Electronic Remittance (required)</li><li>Epic Resolute Professional Billing SBO Certification (preferred)</li><li>Minimum of three years' experience as a certified Epic analyst</li></ul><p></p><p><b><i><br>
** In compliance with Covid-19 Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **</i></b></p></div>

Analyst III, Epic Professional Billing Claims

<p></p><div><p><b>Title</b>: Epic Analyst I, Professional Billing &amp; Claims
<br>
<b>Reports to</b>: Manager of Professional Billing and Claims
<br>
<b>Classification</b>: Individual Contributor<br>
<b>Location</b>: Boston (Hybrid)<br>
<b>Job description revision number and date</b>: V: 3.0; 11.3.2025</p><p><br>
Organization Summary:<br>
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Quality Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving 150,000 Medicaid beneficiaries who receive primary care at 18 health centers across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities and to strengthen our health center partners.</p><p><br>
Job Summary:<br>
The Professional Billing Claims Analyst II position will be housed under a new subsidiary organization of C3, Community Technology Cooperative, LLC (CTC). To implement, maintain, support, and maximize the use of clinical, financial, and administrative portions of the software applications utilized by CTC in conducting daily operations under the direction of the Manager of Professional Billing and Claims. This includes:</p><div><ul><li><br>
Maintaining current clinical, financial, and administrative applications, implementing new clinical, financial, and administrative applications</li><li>Assisting in the assessment of workflow processes and assisting in process re-engineering to achieve efficiencies in departmental operations</li><li>Assisting users in developing reports and analyses, troubleshooting, and resolution of application issues</li><li>Working with the IT Education staff to assist in training users and in the development of documentation</li><li>Maintaining a level of knowledge about IT operations and network issues and maintaining current industry knowledge</li></ul></div><div><br>
Responsibilities:<br>
<ul><li>Ability to maintain current system applications</li><li>Facilitate end users&rsquo; ability to understand and maximize the use of the software to perform daily operations</li><li>Evaluate user knowledge and work with IT education staff to develop specialized training when necessary; educate users in system optimization</li><li>Acts as liaison between users and the software vendor(s)</li><li>Guides the modification of system applications in instances where current applications impede performance or where changes will enhance performance</li><li>Ensure system application updates are working properly before updates are loaded into the live system by coordinating testing and update dates with users and vendors</li><li>Integrate new application(s) in the existing HIS according to the implementation schedule</li><li>Respond to user questions with timely answers and/or referral to appropriate department/person</li><li>Assist users with technical problems by alerting HIS Operations staff to the need for repair or investigation</li><li>Coordinate with Database Analysts to provide expertise in the development of reports and analyses</li><li>Work with other IT staff to ensure interfaces between applications and systems are functioning properly</li><li>Maintain and periodically review dictionaries, assist in entering and maintaining user codes, maintain the security of applications, and ensure consistency between various dictionaries</li><li>Investigate on timely basis discrepancies in statistics which could indicate a problem with the accuracy of data</li><li>Work with application managers, staff from affected areas, and representatives from other impacted areas, to analyze computer system functions and compare data and existing systems both functionally and procedurally</li><li>Implement new clinical, financial, and administrative software, including add-on features, and/or new routines in existing applications</li><li>Participates with other IT staff and other clinical, financial, and administrative areas in the planning and implementation stages of the application, including the development of dictionaries</li><li>Work with Department Managers and IT Education staff to ensure training programs for use of applications are developed and conducted for all levels of users and participate in such programs when needed</li><li>Develop system documentation to supplement vendor manuals and which defines processes, procedures, and policies regarding utilization of various functions</li><li>Assist departments with the development of downtime procedures</li><li>Work with Operation Manager and staff to establish schedules for report production and system jobs to maintain balanced system utilization and minimize system degradation, if necessary</li><li>Sustain working knowledge of key functions of all aspects of the department in order to provide emergency coverage in the absence of others in the department</li><li>Work with Applications Manager to accomplish other departmental tasks</li><li>Notify the Applications Manager of requests for custom modifications to standard applications and of any updates to standard systems which replace existing custom modifications so that the Application Manager can take appropriate action</li><li>Assist in the development of IT policies and procedures and notify users as appropriate</li><li>Participate in applications on-call rotation for the information system</li><li>Participate in workgroups and committees as necessary</li><li>Demonstrates competent and effective job performance skills as evidenced by the volume, skill, and technical knowledge of work performed, neatness, accuracy, thoroughness, and completeness, and the ability to follow instructions</li><li>Strong attention to detail</li><li>Ability to manage multiple priorities in an effective and organized manner</li><li>Demonstrates the ability to interact effectively and in a professional manner with peers</li></ul>
Administration, and other customers as demonstrated by willingness to work with others to achieve CTC&rsquo;s goals<br>
<ul><li>Ability to present a friendly and positive manner, willingness to seek additional tasks</li><li>Responsibility to assist the department and/or peers, ability to be flexible and perform new tasks and adjust to change even under pressure</li><li>Ability to accomplish results by working effectively with or through other people</li><li>Ability to hear and communicate with others in a clear, understandable, and professional manner in person and on the phone</li><li>Ability and commitment to provide outstanding customer service</li><li>Ability to actively listen, demonstrate patience and empathy, and authentically engage with individuals in a caring and helpful manner</li><li>Ability to identify and resolve problems and maintain composure and sound judgment in difficult or stressful situations</li><li>Maintain current industry knowledge by attending industry seminars, reviewing professional literature, and communicating on a regular basis with other IT analysts</li><li>Required to travel onsite for site visits and project milestones either at the health center or the CTC office in Boston</li></ul></div><p></p><div><br>
Required Skills:<br>
<ul><li>Ability to understand, analyze, document, and explain business processes and the data that underly them</li><li>Experience working with Electronic Health Records, medical claims, and other health care data</li><li>Experience working with Clearinghouses to facilitate claims transmission preferred</li><li>Flexible and adaptable to change in a fast-paced environment</li><li>Demonstrated ability to work both independently and as part of a team</li><li>Demonstrated ability to thrive in a fast-past environment</li><li>Nuanced interpersonal communication skills</li><li>Weekly on-call will be a requirement for this position</li></ul></div><p></p><div><br>
Desired Other Skills:<br>
<ul><li>Familiarity with the MassHealth ACO program</li><li>Familiarity with Federally Qualified Health Centers</li><li>Experience working in a provider organization</li><li>Experience working in a managed care environment</li><li>Experience with anti-racism activities, and/or lived experience with racism is highly preferred</li></ul></div><p></p><div><br>
Qualifications:<br>
<ul><li>Bachelor&rsquo;s degree in a healthcare-related field, Information Systems or Business Management</li><li>Resolute Professional Billing Claims Administration and Electronic Remittance certification preferred, but not required</li><li>0-1 years of healthcare or Epic experience</li><li>Prior EHR support experience preferred, but not required</li></ul></div><p><b><i><br>
** In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **</i></b></p></div>

Analyst I, Professional Billing & Claims

<div><p><b>Title: </b>Interface Analyst III<br>
<b>Reports to: </b>Manager, Integrations<br>
<b>Classification: </b>Individual Contributor<br>
<b>Location: </b>Boston (Hybrid)<br>
<b>Job description revision number and date: </b>V 2.0,12.22.2025</p><h1 class="jobSectionHeader"><b>
Organization Summary:</b></h1><div>
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.</div><h1 class="jobSectionHeader"><b>
Job Summary:</b></h1><p>
The interface Analyst III position will be housed under a subsidiary organization of C3, Community Technology Cooperative, LLC (CTC) to implement, maintain, support, and maximize the use of clinical, financial, and administrative portions of the software applications utilized by CTC in conducting daily operations under the direction of the Manager of Integrations and Interfaces. This includes:</p><br>
<div></div><ul><li>
Maintaining current clinical, financial, and administrative applications, implementing new clinical, financial, and administrative applications</li><li>
Assisting in the assessment of workflow processes and assisting in process re-engineering to achieve efficiencies in departmental operations</li><li>
Assisting users in developing reports and analyses, troubleshooting, and resolution of application issues</li><li>
Working with the IT Education staff to assist in training users and in the development of documentation</li><li>
Maintaining a level of knowledge about IT operations and network issues and maintaining current industry knowledge</li></ul><h1 class="jobSectionHeader"><b>
Responsibilities:</b></h1><ul><li>
Ability to maintain current system applications</li><li>
Facilitate end users&rsquo; ability to understand and maximize the use of the software to perform daily operations</li><li>
Evaluate user knowledge and work with IT education staff to develop specialized training when necessary; educate users in system optimization</li><li>
Acts as liaison between users and the software vendor(s)</li><li>
Guides the modification of system applications in instances where current applications impede performance or where changes will enhance performance</li><li>
Ensure system application updates are working properly before updates are loaded into the live system by coordinating testing and update dates with users and vendors</li><li>
Integrate new application(s) in the existing HIS according to the implementation schedule</li><li>
Respond to user questions with timely answers and/or referral to appropriate department/person</li><li>
Assist users with technical problems by alerting HIS Operations staff to the need for repair or investigation</li><li>
Coordinate with Database Analysts to provide expertise in the development of reports and analyses</li><li>
Work with other IT staff to ensure interfaces between applications and systems are functioning properly</li><li>
Maintain and periodically review dictionaries, assist in entering and maintaining user codes, maintain the security of applications, and ensure consistency between various dictionaries</li><li>
Investigate on timely basis discrepancies in statistics which could indicate a problem with the accuracy of data</li><li>
Work with application managers, staff from affected areas, and representatives from other impacted areas, to analyze computer system functions and compare data and existing systems both functionally and procedurally</li><li>
Implement new clinical, financial, and administrative software, including add-on features, and/or new routines in existing applications</li><li>
Participates with other IT staff and other clinical, financial, and administrative areas in the planning and implementation stages of the application, including the development of dictionaries</li><li>
Work with Department Managers and IT Education staff to ensure training programs for use of applications are developed and conducted for all levels of users and participate in such programs when needed</li><li>
Develop system documentation to supplement vendor manuals and which defines processes, procedures, and policies regarding utilization of various functions</li><li>
Assist departments with the development of downtime procedures</li><li>
Work with Operation Manager and staff to establish schedules for report production and system jobs to maintain balanced system utilization and minimize system degradation, if necessary</li><li>
Sustain working knowledge of key functions of all aspects of the department in order to provide emergency coverage in the absence of others in the department</li><li>
Work with Applications Manager to accomplish other departmental tasks</li><li>
Notify the Applications Manager of requests for custom modifications to standard applications and of any updates to standard systems which replace existing custom modifications so that the Application Manager can take appropriate action</li><li>
Assist in the development of IT policies and procedures and notify users as appropriate</li><li>
Participate in applications on-call rotation for the information system</li><li>
Participate in hospital quality teams and committees as necessary</li><li>
Demonstrates competent and effective job performance skills as evidenced by the volume, skill, and technical knowledge of work performed, neatness, accuracy, thoroughness, and completeness, and the ability to follow instructions</li><li>
Demonstrates the ability to interact effectively and in a professional manner with peers</li><li>
Administration, and other customers as demonstrated by willingness to work with others to achieve CTC&rsquo;s goals</li><li>
Ability to present a friendly and positive manner, willingness to seek additional tasks</li><li>
Responsibility to assist the department and/or peers, ability to be flexible and perform new tasks and adjust to change even under pressure</li><li>
Ability to accomplish results by working effectively with or through other people</li><li>
Ability to hear and communicate with others in a clear, understandable, and professional manner in person and on the phone</li><li>
Demonstrated use of good written and verbal communication skills</li><li>
Maintain current industry knowledge by attending industry seminars, reviewing professional literature, and communicating on a regular basis with other IT analysts</li><li>
Other duties as assigned</li></ul><h1 class="jobSectionHeader"><b>
Required Skills:</b></h1><ul><li>
Ability to understand, analyze, document, and explain business processes and the data that underly them</li><li>
Experience working with Electronic Health Records, medical claims, and other health care data</li><li>
Flexible and adaptable to change in a fast-paced environment</li><li>
Demonstrated ability to work both independently and as part of a team</li><li>
Demonstrated ability to thrive in a fast-past environment</li><li>
Nuanced interpersonal communication skills</li><li>
Weekly on-call will be a requirement for this position</li></ul><h1 class="jobSectionHeader"><b>
Desired Other Skills:</b></h1><ul><li>
Familiarity with the MassHealth ACO program</li><li>
Familiarity with Federally Qualified Health Centers</li><li>
Experience working in a provider organization</li><li>
Experience working in a managed care environment</li><li>
Experience with anti-racism activities, and/or lived experience with racism is highly preferred</li></ul><p><b>
Qualifications:</b></p><ul><li>
Bachelor&rsquo;s degree in a healthcare-related field, Information Systems or Business Management</li><li>
Required certifications in Epic Bridges and at least one additional Epic application/module</li><li>
Preferred certification in Rhapsody Professional</li><li>
Minimum of three years of build experience as a certified/credentialed Epic Analyst</li></ul><p></p><div><b><i><br>
** In compliance with Covid-19 Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **</i></b></div></div>

Analyst III, Interface

Alan Gray, Inc.

<div><div><div><b>Summary </b>: This role is responsible for data analytics and reporting for the SIMS platform. This role develops and manages client reporting needs. This role fulfills any reporting requirements for internal staff in finance, executive, account management and operations. This role provides client support and implementation services for SIMS existing and new clients. The Data Analyst is part of the Technical Operations team and reports to the Operations Manager. S uccess in this role requires extensive experience in customer service, strong product knowledge and a varied technical acumen.<br>
</div><div></div><div><b>Responsibilities include but not limited to:
</b></div><div><ul><li>Developing and maintaining all SIMS client reporting and requests.
</li><li>Managing client data within the SIMS platform
</li><li>Providing all monthly billing reports for client invoicing to Finance
</li><li>Creating custom reports for internal and external shareholders
</li></ul></div><ul><li>Timely monthly client billing reports
</li><li>Administration of dashboards for managing business operations
</li><li>Quality assurance of SQL Data for SIMS platform
</li><li>Oversee inbound data validation and import process.
</li><li>Assist as needed in the onboarding and implementation of new clients onto the SIMS platform
</li><li>Triage, report and escalate system, performance and client related and application issues
</li><li>Communicate between business, development team and Ops leadership.
</li><li>Work with the development team to provide timely support for any client&rsquo;s needs.
</li><li>Open and document application issues for Development review
</li><li>Handle and process incoming customer service requests through ticketing system or via emails
</li>Maintain ongoing contact with business and developers and stay up to date on system limitations, upgrades and capabilities to always ensure peak system performance.<br>
<li>
<br>
</li></ul><div><b>Qualifications </b>:
</div><div><ul><li>Bachelor&rsquo;s degree in computer science, related degree or equivalent work experience.
</li><li>Strong and demonstrable analytical and reporting skills
</li><li>Experience supporting a SaaS based application
</li><li>Possess the ability to work in a fast-paced and flexible environment.
</li><li>Must be customer focused.
</li><li>Must be able to work individually and within a team framework.
</li>Strong documentation and communication skills.<br>
<li>
</li></ul></div><div></div><div><b>Additional Required Skills:
</b></div><div><ul><li>Microsoft Office Suite
</li><li>Strong working knowledge of Microsoft SQL Server
</li><li>Experience with Reporting Tools (i.e. Crystal Report and Power BI)
</li><li>Experience with HubSpot CRM
</li><li>Experience with JIRA
</li></ul></div><ul><li>Previous Experience with Legal Billing Software Beneficial</li></ul></div></div>

Data Analyst

Alan Gray LLC

<div><div><b>Summary</b>: This role is responsible for data analytics and reporting for the SIMS platform. This role develops and manages client reporting needs. This role fulfills any reporting requirements for internal staff in finance, executive, account management and operations. This role provides client support and implementation services for SIMS existing and new clients. The Data Analyst is part of the Technical Operations team and reports to the Operations Manager. Success in this role requires extensive experience in customer service, strong product knowledge and a varied technical acumen.</div><div></div><div><b><br>
Responsibilities include but not limited to:</b></div><div><ul><li>
Developing and maintaining all SIMS client reporting and requests.</li><li>
Managing client data within the SIMS platform</li><li>
Providing all monthly billing reports for client invoicing to Finance</li><li>
Creating custom reports for internal and external shareholders</li></ul></div><ul><li>
Timely monthly client billing reports</li><li>
Administration of dashboards for managing business operations</li><li>
Quality assurance of SQL Data for SIMS platform</li><li>
Oversee inbound data validation and import process.</li><li>
Assist as needed in the onboarding and implementation of new clients onto the SIMS platform</li><li>
Triage, report and escalate system, performance and client related and application issues</li><li>
Communicate between business, development team and Ops leadership.</li><li>
Work with the development team to provide timely support for any client&rsquo;s needs.</li><li>
Open and document application issues for Development review</li><li>
Handle and process incoming customer service requests through ticketing system or via emails</li><li>
Maintain ongoing contact with business and developers and stay up to date on system limitations, upgrades and capabilities to always ensure peak system performance.</li></ul><div><b><br>
Qualifications</b>:</div><div><ul><li>
Bachelor&rsquo;s degree in computer science, related degree or equivalent work experience.</li><li>
Strong and demonstrable analytical and reporting skills</li><li>
Experience supporting a SaaS based application</li><li>
Possess the ability to work in a fast-paced and flexible environment.</li><li>
Must be customer focused.</li><li>
Must be able to work individually and within a team framework.</li><li>
Strong documentation and communication skills.</li></ul></div><div></div><div><b><br>
Additional Required Skills:</b></div><div><ul><li>
Microsoft Office Suite</li><li>
Strong working knowledge of Microsoft SQL Server</li><li>
Experience with Reporting Tools (i.e. Crystal Report and Power BI)</li><li>
Experience with HubSpot CRM</li><li>
Experience with JIRA</li></ul></div><ul><li>
Previous Experience with Legal Billing Software Beneficial</li></ul></div>

Action for Boston Community Development, Inc., (ABCD)

<div><h3 class="jobSectionHeader"><b>Description</b></h3><div><br>
The <b>Data and Billing Coordinator</b> is responsible for third party billing and the data management aspects for the ABCD Family Planning Partnership. This is an integral role in the program which serves as a liaison between the family planning team, sub recipient agencies and outside vendors for both data management and third party billing.</div><h3 class="jobSectionHeader"><b><br>
Key Responsibilities</b></h3><br>
<ul>
<li>
Coordinate and carry out all third party billing for ABCD Family Planning program including Unit Rate. Review editing of all billing data for completeness and accuracy, and prepare one line reports. Maintain communication with ABCD central office on all aspects of department billing system needs.</li>
<li>Provide technical assistance and administrative training for ABCD central and delivery site staff on client visit billing, 340B contraceptive supplies and data collection systems.</li>
<li>Conduct quality assurance activities through delivery site administrative and billing reviews to ensure compliance with state, federal, pharmacy and billing regulations.</li>
<li>Monitor the 340B use by service sites including maintaining accurate records of addresses, provider NPIs, and recertification. Conduct regular audits to ensure 340B compliance.</li>
<li>Monitor and prepare reports on utilization of delivery site progress toward stated goals at least quarterly. Responsible for developing corrective actions plans if utilization is below the expected threshold.</li>
<li>Prepare data reports for federal and state reporting requirements. Generate data reports and projections for grants as needed.</li>
<li>Assist with the development of administrative policies, protocols, and training materials.</li>
<li>Supervise the data analyst; provide oversight for data uploads, error rates, and data reporting. Ensure that all online and exported Family Planning Encounter Records (FPERs) are received from the delivery sites and accurately edited for quality assurance on a continuing basis.</li>
<li>Responsible for Family Planning Program&rsquo;s compliance with Health Information Portability and Accountability Act &ldquo;HIPAA&rdquo; in regards to clinical and billing Family Planning Encounter Records (FPER) data.</li>
<li>Represent ABCD Family Planning data interests on federal and state policy committees.</li>
<li>Perform other related duties as assigned from time to time.</li></ul><br>
<h3 class="jobSectionHeader"><b>
Skills, Knowledge and Expertise</b></h3><br>
<ul>
<li>
Minimum of a Bachelor&rsquo;s Degree in Human Service Administration or related field, and 3-5 years of relevant experience required.</li>
<li>Supervisory experience and previous office work experience in a human service agency preferred.</li>
<li>Ability to maintain confidentiality at all times.</li>
<li>Willingness and ability to work independently as well as a member of a team.</li>
<li>Flexibility, initiative, and ability to work in a team required.</li>
<li>Ability to deal sensitively and effectively with individuals of diverse economic and cultural backgrounds.</li>
</ul><div>Expected Salary: $64,064.00 USD. Salary scales are set according to an explicit compensation policy and relevant market data. Due to funding restrictions and our strong focus on internal parity, this salary is thoughtfully aligned with the duties expected for this role, and offers are firm.</div><h3 class="jobSectionHeader"><b><br>
Why Work Here</b></h3><br>
<ul>
<li>
Make a Difference: Every day, your work directly impacts the lives of thousands in the Greater Boston community, empowering them and making positive, lasting change.</li>
<li>Inclusive Environment: ABCD values the diversity of its workforce, with an inclusive culture that respects individuality and promotes collaboration.</li>
<li>Continuous Learning: We offer numerous training and development opportunities, ensuring our staff remain at the forefront of community action methodologies and strategies.</li>
<li>Comprehensive Benefits: At ABCD, we take care of our own, providing a competitive benefits package, including health coverage and retirement plans.</li>
<li>A Legacy of Impact: Join an organization that boasts a legacy spanning over half a century, consistently championing the rights and needs of our community's most vulnerable.</li>
<li>Teamwork &amp; Camaraderie: Be a part of a passionate team, united in their mission to combat poverty, and ensure every individual can reach their fullest potential.</li></ul><br>
<h3 class="jobSectionHeader"><b>
About Action for Boston Community Development</b></h3><div>
ABCD is the shortest distance between two points &mdash; from where you are to where you want to be. Discover the tools and resources you need to move from poverty to stability and from stability to success.</div></div>

Data & Billing Coordinator

<div><p><b>Title</b>: Senior Analyst, Quality Data<br>
<b>Reports to</b>: Director of Analytics<br>
<b>Classification</b>: Individual Contributor<br>
<b>Location</b>: Boston (Hybrid)<br>
<b>Job description revision number and date</b>: V:2.0; 10.20.2025</p><p><br>
Organization Summary:<br>
Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners.</p><p><br>
Job Summary:<br>
The Senior Quality Data Analyst is a key member of the analytics team working directly with the Director of Analytics, Director of Quality, and Senior Manager of Quality Programs. This role supports the organization&rsquo;s mission by providing critical analytical and technical expertise to the Quality and Health Equity Programs.<br>
The Analyst collaborates across internal departments and with external partners, especially Federally Qualified Health Centers (FQHCs) to manage Health Equity program analytics, population health reporting, and data-driven decision-making. The Analyst must be able to independently analyze complex healthcare data, draw meaningful conclusions, and communicate findings effectively to senior leadership. A customer-service mindset and a collaborative approach are essential for success in this role.</p><div><br>
Responsibilities:<br>
<ul><li>Monitor and analyze performance on quality and health equity measures that impact shared savings, incentive payments, and compliance under the Medicaid, Medicare, and Commercial value-based contracts</li><li>Generate clear, actionable reports, dashboards, and insights to support clinical, operational, and strategic decision-making across internal teams and FQHC partners</li><li>Translate analytical findings into strategic insights that inform interventions and drive improved outcomes and financial performance for ACO leadership and FQHCs</li><li>Query and analyze large data sets to generate clear, concise reports and dashboards for both routine and ad hoc needs, supporting internal and external stakeholders</li><li>Ensure accuracy, completeness, and integrity of data used for quality reporting, regulatory submission, and performance monitoring</li><li>Lead data validation, preparation, and process improvement efforts to ensure consistency and reliability across reporting processes</li><li>Partner with Quality and Clinical teams, serving as a strategic partner in cross-departmental workgroups and planning sessions to ensure alignment on data use, shared goals, and coordinated efforts</li><li>Collaborate with IT to improve the capture and completeness of demographic and SDOH data</li><li>Support reporting efforts related to CMS, Medicaid, and health plan reporting requirements related to quality and health equity performance</li></ul></div><div>
Required Skills:<br>
<ul><li>Experience working with healthcare quality and health equity metrics (e.g., HEDIS, eCQMs, MSSP, and other state Medicaid programs)</li><li>Experience querying and manipulating large data sets using computational tools; SQL or similar language required; experience in other tools like SAS, R, or Python is a plus</li><li>Skilled in extracting actionable insights from complex, unstructured data sets to support strategic business objectives</li><li>Strong communication skills with the ability to present complex information clearly to both technical and non-technical audiences</li><li>Proficiency in Excel required; experience with data visualization tools such as Tableau, Power BI, or Qlik&mdash;or willingness to learn&mdash;is essential</li><li>Demonstrated ability to work independently, manage competing priorities, and maintain attention to detail in a fast-paced environment</li><li>Commitment to accuracy, integrity, and high-quality deliverables</li><li>Experienced with developing models that achieve objectives with minimum required complexity</li></ul></div><div>
Desired Other Skills:<br>
<ul><li>Experience working with medical claims and payment methodologies including MassHealth data (or other Medicaid and Medicare data sets)</li><li>Familiarity with other healthcare quality measurement frameworks</li><li>Demonstrated understanding of value-based care models, managed care contracting, or financial modeling</li><li>Ability to design, execute, and summarize clinical and population health analyses that identify actionable insights for Quality teams</li><li>Experience supporting or partnering with Federally Qualified Health Centers (FQHCs)</li><li>Experience with anti-racism activities, and/or lived experience with racism is highly preferred</li></ul></div><div>
Qualifications:<br>
<ul><li>Bachelor&rsquo;s degree required; advanced degree in business, economics, statistics, public health, or related fields strongly preferred</li><li>Four or more years of practical experience in healthcare or analytics with at least two years focused on healthcare data</li></ul></div><p><b><br>
** In compliance with Infection Control practices per Mass.gov recommendations, we require all employees to be vaccinated consistent with applicable law. **</b></p></div>

Senior Analyst, Quality Data

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