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Core Systems Configuration Specialist I (Temporary with Benefits)

Job Category:  Information Technology
Department:  Enterprise Configuration
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  6225

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary


The Core Systems Configuration Specialist I ensures the timely and appropriate configuration of the core systems by processing, validating and maintaining provider network affiliations, contract affiliations, and updating  data in master reference data tables.  This position ensures and validates the required and appropriate information has been provided by business stakeholders and will collaborate, as needed, with them to obtain the necessary data to support the correct system updates.   This position works closely with other members of the department to help ensure the optimal configuration of the systems and applications, taking into consideration organizational requirements, related standards, and best practices for the configuration. 

Duties


Load, maintain and validates provider affiliation and contract data to ensure the accurate processing of claims.

 

Reviews and audits provider records and associated affiliations for quality and accuracy.

 

Ensures accuracy of the data received and informs requestor of document requirements to make system updates.

 

Performs data maintenance and updates of reference system tables validating data accuracy.

 

Identify issues, participates and assists with the resolution and correction of simple to moderate configuration-related issues.

 

Participates and provides input in related cross-functional process improvement initiatives and activities.

 

Perform other duties as assigned.

Education Required
Bachelor's Degree in Business Administration or Healthcare Related Field
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Experience

Required:
At least 1-2 years of experience in a Systems Configuration, Claims or other Operations department. Claims experience with QNXT or equivalent processing system.

 

Preferred: 
At least 1 year of experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management services organization.

Skills

Required:
Basic knowledge of Microsoft Excel

 

Good communication, analytical, organizational, and time-management skills.

 

Able to meet strict, tight deadlines with a high level of accuracy

 

Able to prioritize multiple tasks.

Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Additional Information

 

L.A. Care offers a wide range of benefits including

  • Paid Sick Leave
  • 457 (b) Retirement Plan
  • 529 College Savings Plan