Regulatory Reporting Specialist - Technical

Your career starts now. We're looking for the next generation of health care leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, PA, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Role Overview:

The Regulatory Reporting Technical Specialist is responsible for providing technical expertise to the department by identifying, developing, and implementing systematic solutions that improve the efficiency of regulatory reporting processes while maintaining high standards of accuracy, data integrity, and timeliness.

Work Arrangement:

- Remote within the United States, working Eastern Standard Time.

Responsibilities:

- Leads the development, management, and implementation of multiple projects ranging from small initiatives to complex efforts. Coordinates project phases, resources, requirements, and deliverables.
- Serves as a technical lead within the department, providing technical expertise, training, and guidance to departmental management and staff.
- Develops and maintains comprehensive knowledge of data sources used for regulatory reporting, including, but not limited to, the Data Warehouse, Facets, JIVA, FEI, and the Reports Database.
- Designs, develops, manages, and implements customized, user-friendly technical solutions that automate complex reporting requirements across multiple lines of business. Uses relational databases and other reporting tools to improve the efficiency, consistency, and accuracy of report completion
- Creates and maintains detailed documentation of reporting processes and technical solutions, including explanations of underlying programming logic and clear instructions to support the transition of solutions to end users.
- Collaborates with end users and department management to develop and implement appropriate testing procedures for technical solutions. Performs benchmarking, validation, and reconciliation analyses to ensure the accuracy and integrity of reported data.
- Coordinates solution development across all project phases, including coding, data, resource, and business requirements. Works effectively with users, developers, internal departments, and external contacts as appropriate.
- Identifies and evaluates opportunities to improve reporting quality, efficiency, and processes. Conducts analysis and research and communicates recommendations to appropriate decision-makers.
- Provides recommendations and participates in operational decision-making related to systems, reporting tools, processes, and procedures used to support data integrity and reporting efficiency.
- Identifies and analyzes data and reporting anomalies; researches, tests, and validates results; and provides clear explanations for identified variances and changes. Documents agreed-upon explanations in formal notes to file and communicates them to Regulatory Reporting management.

Education/Experience:

- Bachelor’s Degree or equivalent experience required.
- 6 years of experience in Information Services, Reporting, Claims, Managed Care, or Healthcare environment required.
- Proficiency in Microsoft Access, Excel, Word and Relational Database Design, SQL, and SSRS.
- Basic knowledge of Databrick, POWER BI and VBA programming, highly preferred.
- Thorough understanding of business computer programs, applications, and systems, database structures, and data files required.
- Ability to train staff in all aspects of Regulatory Reporting and to provide continued updates as policies and procedures change.
- Complete understanding of reporting or data analysis processes.
- Strong communication (both written and verbal), analytical, and problem-solving skills.
- Strong organizational skills with the ability to coordinate several projects simultaneously.
- General understanding of claims processing, clinical coding, and basic business practices.
- Ability to appropriately extract and manipulate data from a variety of sources and databases.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.