Managed Care Systems Analyst 1

Non-Remote position

Under the direction of the Director of Business Intelligence and EZCAP Applications, this position is responsible to maintain the data integrity of the Managed Care System and provide support to and train users on the appropriate modules of the system; is the liaison with Vendor, IT, and Managed Care department teams across the organization.  Manages projects such as upgrades, encounter reconciliation and EDI transactions.  The Managed Care Systems Analyst 1 will interact with other departments, clinic personnel, and outside providers in a professional and friendly manner, to create and maintain a positive relationship with our internal and external customers.

• Provide Support and training to end users on the appropriate modules of the managed care systems and any third-party related systems.
• Troubleshoot, test, report, track and implement resolution of application specific issues reported by end users.
• Is the liaison between the Vendor, IT, Director over the managed care system, related third party applications and the end user.
• Manages projects and participates on teams to ensure integration of managed care system and other department process changes are evaluated and implemented appropriately to maintain data integrity.
• Recommends and implements system changes and enhancements to improve processes.
• Updates and maintains master file data in Managed Care systems and related applications.
• Serves as principal resource in maintaining daily system balancing, data dictionaries, extract logic, request log, master tables, and other system related documentation.
• Coordinates projects for software updates/ upgrades and testing for the managed care system.
• Monitors and facilitates data integration with source systems.
• Troubleshoots file import problems.
• System specific EDI support for in-loading of data through application module.
• Act as primary back up for EDI Data Analyst role.
• Responsible for updating configuration for 837,277 and 835 EDI files as needed.
• Gather requirements, define, document and analyze business needs under the guidance of the Director of Business Intelligence, and IT.
• Work with functional team(s) to analyze “as-is” and “to-be” business processes.
• Development of test plans, testing, training, deployment and support of new development or business system processes.
• Monitors encounter submissions and reconciliation. Participates in group discussions and meetings as well as researches and implements resolutions for encounter rejections.
• Other duties as assigned.
• This position is eligible for remote/hybrid work consideration. Remote/Hybrid approval will be on a case-by-case basis taking into consideration business needs, performance metrics and an evaluation of the likelihood of the employee succeeding in a remote work arrangement (determined by their supervisor). Employees in a remote work arrangement may be required to attend in person meetings as needed to meet business and departmental needs.

• 8.1 Bachelor’s degree in Business Management, Information Systems or related field.  Education may be substituted with data analytics, system support or relevant analytical work experience on a year for year basis and will be reviewed individually.
• 8.2 Required Skills:

a.) At least 1 year of system or application support.

b.) Excellent communication skills – ability to tailor communication to audience (technical and non-technical).

c.) Understanding of database structure and principles

• 8.3 Desired Skills:

d.) Managed Care / Healthcare Information Systems experience

e.) EDI Claims transaction experience

f.) Ability to develop SQL procedures and scripts

g.) Experience with SQL Server Report Services

• 8.4 Valid CA Driver’s License and current vehicle insurance.

The pay range for this position at commencement of employment is expected to be reasonably between $34.84 and $40.99. However, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.