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Provider Network Operations Data Support Specialist I

Job Category:  Provider Relations
Department:  Provider Data Management
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  8281

 

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.

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary

The Provider Network Operations Data Support Specialist I assists the Provider Network Operations (PNO) core systems and 5 business programs. This position is responsible to assist in the monitoring of ongoing systems status, trouble-shooting, overviewing electronic data file exchanges, reconciling data received with data accepted and/or rejected for the Provider Sync and other processes. The tasks including data quality assurance, process development, specification documentation and report developing.

 

The position applies technical skills and systems skills to maintain system efficiency, troubleshoot operational problems, report on systems problems, plan for systems conversions and upgrades, support design, development, and generation of ad hoc or production reports from self-service reporting systems or in conjunction with the reporting team. The data analysis/integration projects are those which may require periodic maintenance on a weekly, monthly, quarterly, biannual, or annual basis. The position works with QNXT, MHC, and MPD systems teams to assist in the planning, testing, and pre-deployment activities which are executed fully to a high standard. The Data Support Specialist may collaborate with Information Technology analysts and key staff from Membership and finance to verify processes, policy, and related data.   

 

The position interprets and documents both written and verbal systems, business, and report specifications. The position takes basic instructions, requirements, specifications and assists other department members in driving positive business outcomes, which may include: interviewing key staff to ensure that they are providing  reporting and guidance on core processes. With support, the position will work with several departments across the organization to ensure smooth operattions including, enrollment, membership, encounters, and finance.  

Duties

Provide PNP Data Support Specialist II and other team members to provide provider data advice on key business processes and system functionality (MPD, QNXT, and MHC) to users in other departments.  

 

Support team in providing key input on troubleshooting and errors from a processes and systems (MPD, QNXT, and MHC) perspective. Work with cross-functional teams to resolve errors in a accurate and timely manner.  Work with the I.T. support  teams to identify issues, develop solutions, and deploy changes to production.

 

In conjunction with reporting staff; assist in the design, development, and generation of ad hoc/production and errors reports.

 

Communicate with stakeholders/clients/collaborators regarding project details and plans.  Support cross-functional consensus based on mutual understanding of business requirements/resource availability.

 

Responsible for assisting depatment in regular reporting of issues dicovered in L.A. Care provider operations.

 

Perform other duties as assigned. 

Education Required

High School Diploma/or High School Equivalency Certificate

Education Preferred

Associate's Degree

Experience

Required:
A minimum of 0-2 years of experience in health services/operations; background in data analysis/integration.

 

Preferred:  
Working knowledge of basic to medium Procedural Language for Structural Query Language (PLSQL), are highly preferred.

Skills

Required:
Working knowledge of basic to medium MS Excel and Access skills.

 

Must demonstrate appropriate attention to detail and efficient organizational skills.  

 

Must demonstrate an aptitude in learning and expanding abilities to use new applications with basic training.   

 

Must be a self-starter who takes charge of assigned projects and ability to manage multiple priorities. 

 

Must have strong communications skills, both verbal and written, inclusive of active listening skills.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Additional Information

 

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

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

 

At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.


Nearest Major Market: Los Angeles

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