MetroPlusHealth Summer Internship: Corporate Compliance

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 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview

This role will involve assisting MetroPlusHealth's Corporate Compliance department with the collection and analysis of data supporting health insurance claims, providers, and members. There will be ample opportunity to learn from and share ideas about addressing a large volume of transactions to quickly identify and research problem areas. A proven ability to work with large sets of data as well as a keen interest in learning new software applications and advanced data handling skills in Excel (pivot tables, filters, table lookups, etc.) are musts. This is essentially a real-life case study in helping to identify trends and exceptions within a large amount of data in a highly complex industry. The candidate selected for this internship has the potential of making lasting enhancements to current processes by bringing fresh insight.

Join us this summer (June - August) for a highly interactive and engaging internship experience where you get to work alongside various departments to develop your skills and learn more about the health insurance and healthcare industry.

Department Requesting: Graduate Student

Interns will also participate in workshops, activities and other events organized by MetroPlusHealth

*Note: This is a paid internship program. Prospective interns must be current students attending an accredited College or University and must be 18 years or older to be considered.

• Working with other members of the team to establish request parameters, generate data sets, and analyze possible problem areas.
• Investigating identified issues through various claims processing and pricing systems as well as other online resources to identify root causes of error. This might involve researching fee schedules, hold codes, provider contract terms, etc.
• Summarizing and reviewing findings with subject matter experts to confirm their validity.
• Recommending enhancements and best practices which might assist in eliminating underlying issues.
• Providing administrative and technical support with other projects and deliverables as assigned. This may include reviewing supporting documentation collected for audits, drafting presentations in PowerPoint, documenting workflows, and/or creating standardized reporting templates.

• Currently working towards the completion of a degree in computer science or another field dependent upon sifting through large volumes of data
• Superior Excel and/or data handling skills (SQL, Python, etc.)
• Health care industry experience a plus
• Very strong analytical skills
• Creative problem-solving abilities
• Ability to work independently and determine a reasonable approach in sometimes ambiguous situations
• Comfortable in team and individual work settings
• An aptitude and eagerness towards learning new data management tools and techniques.

Professional Competencies

• Learning and growth mindset
• Integrity and trust
• Customer focus
• Clear written and oral communication
• Highly organized and results-oriented.
• Excellent computer skills, including the Microsoft Office suite of applications
• The candidate must have the ability to organize and coordinate projects effectively and arrive at meaningful conclusions by utilizing individual judgment, prioritizing effectively, and wisely managing time.

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