Systems Configuration Analyst

Job Category:  Information Technology
Department:  Enterprise Configuration (450)
Location:  Los Angeles HQ, California, US
Position Type:  Full Time
Requisition ID:  547

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.

DUTIES

The Systems Configuration Analyst performs technical and analytical work related to the maintenance, update, etc. of the configuration of the L.A. Care Health Plan Core Systems and related surround systems, applications, and databases (e.g., Clinical Care Advance (CCA), PCT, PDM, QNXT Migration Utility, Claims Test Pro, etc.).

This includes, but is not limited to:

* Maintaining benefit dictionaries, evidence of coverage tables, provider contractual obligations (including capitation and fee-for-service contracts), Division of Financial Responsibility (DoFR), etc. and related documentation.

* Monitoring and review of systems edits, response time issues, etc. and conducting related root cause analysis to help identify issues and provide well thought-out recommendations for resolution

* Serving as a subject matter expert for configuration change management testing and related best practices.

* Facilitating production controls and system configuration data codification.

* Interfacing and collaborating with peers within and outside of the department and the organization to support configuration management best practices, systems enhancement processes, management of the system configuration life cycle management project/program plans, tracking of configuration change operational issues and resolution.

* Identifying and assisting with implementing/enhancing systems and process improvements and best practices.

 

QUALIFICATIONS AND REQUIREMENTS

 

EDUCATION

Required:

High School Diploma 

 

Preferred:

Associate's or Bachelor's Degree in Business or Healthcare related field.

 

EXPERIENCE

Required:

With High School Diploma: 6-8 years of experience in a Systems Configuration, Claims or other Operations department with the demonstrated experience on the following list of knowledge/experience below in a healthcare organization.

Knowledge of and experience with Medicare and Medicaid rules and regulations and related core and surround systems code and data sets, etc.

Knowledge of and experience with interpreting and analyzing complex pricing mechanism and contractual terms with providers, delegated groups and related contractual scenarios.

 

Preferred:

With Associate's Degree: 5 years of experience in a Systems Configuration, Claims or other Operations department with the demonstrated experience on the following list of knowledge/experience below in a healthcare organization.

With Bachelor's Degree: 3-5 years of experience in a Systems Configuration, Claims or other Operations department with the demonstrated experience on the following list of knowledge/experience below in a healthcare organization.

At least 5 years experience working with a California Medi-Cal managed care plan or Commercial health plan, medical group, or management services organization.

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

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program


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