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Enrollment System Analyst

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POST DATE 8/18/2016
END DATE 3/29/2017

Tufts Health Plan Providence, RI

Providence, RI
AJE Ref #
Job Classification
Full Time
Job Type
Company Ref #
Mid-Career (2 - 15 years)
Bachelors Degree


Under the supervision of the manager, the Enrollment Systems Analyst will provide analysis and technical support to the Member Enrollment team supporting the Rhode Island line of business with the Public Plans Divsion. Analyst will research member data in multiple systems to identify the root cause of the data issues. Analyst will be involved with the process from start to finish, including identifying issue, documenting issue, recommending fix, testing fix, etc.

Technical tasks require an understanding of SQL Server database architecture as well as the ability to query databases using SQL, MS Access. Analyst will manipulate data and will build charts and summaries in MS Excel. Analyst will be an abstract and logical thinker with excellent attention to detail. Successful candidate will have the ability to effectively communicate with technical staff as well as business users.

* This position will be based out of our Rhode Island office


* Write and implement SQL program code and queries that extract appropriate data subsets from production environment or internal data warehouse. This includes identifying appropriate major and minor tables, creating and defining variables, determining relevant levels of aggregation.
* Detailed and thorough testing of upgrades and changes made to any software utilized by the Member Enrollment team.
* Assist in the creation, testing, and implementation of new processes to ensure high data quality of member data as it relates to new lines of business.
* Assist manager in performing quality audits to meet the requirements under the Model Audit Rule.
* Write specs and other documentation for member enrollment processes and reports.
* Assist with more complicated tasks such as Monthly report, complex member issues, interacts with IT in relation with 834 and 820 EDI transactions.
* Provide data summaries to the team, create charts and reports using MS Excel, query EVS, update and manipulate member data in batches in an effort to reduce manual edits and data entry.
* Ability to work with all levels of employees in an organization.
* Maintains professional growth and development through courses, cross-training, goal-setting and self-directed learning.
* Attend meetings as subject matter expert on Member Enrollment.
* Perform other duties as assigned.


* Bachelors degree in computer science, business, mathematics, economics, statistics, or finance or equivalent work experience of 2-3 years in an analytical and technical role.
* Ability to write SQL queries, preferably in a managed care insurance environment.
* Intermediate MS Excel skills are required.
* Proven analytical ability.
* Requires an abstract thinker.
* Exceptional attention to detail.


Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled


Founded in 1979 as a non-profit health maintenance organization (HMO), Tufts Health Plan is one the country's largest HMO offering a full array of healthcare coverage options to individual consumers and employer groups. Tufts Health Plan has received high marks for its quality from a variety of third parties including U.S News & World Report and Newsweek.