About this role
Salary Range: $91,536.00 (Min.) - $121,286.00 (Mid.) - $151,034.00 (Max.) 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, 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 Surround Systems Configuration Analyst III is responsible for the more complex technical and analytical work related to the maintenance, update, etc. of the configuration of the L.A. Care Health Plan Surround Systems, applications, and databases (e.g., Clinical Care Advance (CCA), Process Communication Tracking (PCT), SyntraNet, etc.). This position serves as a subject matter expert who has the ability to proactively identify and independently rectify issues and opportunities for configuration improvements. As the subject matter expert, this position performs peer review and applies advanced skillset to ensure quality of the work product.
This position collaborates closely with peers and management within the department as well as throughout and outside of the organization to troubleshoot and facilitate the maintenance and update of the most complex configuration of the various modules of our surround systems, applications, and databases as well as facilitate end-to-end interdepartmental and enterprise projects. This position also provides well thought-out recommendations for vendor enhancement of the surround systems products.
Duties
- Manage complex surround systems configuration and related documentation.
- Serve as a subject matter expert for configuration change management testing and related best practices.
- Facilitate production controls and system configuration data codification.
- Monitor and review systems edits, response time issues, etc. and conduct related advanced root cause analysis to identify issues and provide well thought-out recommendations for resolution.
- Identify and facilitate the implementation/enhancement of systems, process improvements, and best practices.
- Interface and collaborate with peers within and outside of the department and 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.
- Perform peer review for all levels of staff and apply advanced skillset to ensure quality of the work product.
- Applies subject expertise in evaluating business operations and processes.
- Identifies areas where technical solutions would improve business performance.
- Consults across business operations, providing mentorship, and contributing specialized knowledge.
- Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices.
- Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.
- Perform other duties as assigned.
Duties Continued Education Required Bachelor's Degree in Business or Healthcare Related Field In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred Experience Required: At least 5 years of experience in a Systems Configuration, Claims or other Operations department in a healthcare organization.
Advanced knowledge of and experience with health plan configuration (especially for health services/medical management/population health management as well as appeals and grievances systems, applications, etc.) and Milliman care guidelines (MCGs) and standards.
Knowledge of and experience with utilizing SDLC and related configuration change management methodologies, standards and best practices.
Preferred: At least 5 years of experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management services organization.
- Skills Required: Advanced understanding of managed care operations (including, but not limited to, health services/medical management/population health management, appeals and grievances, etc.) and the systems that support these operations.
- Knowledge of Systems Development Life Cycle (SDLC) procedures in planning system configuration.
- Strong communication, analytical, organization, and time management skills.
- Able to manage projects and initiatives end-to-end.
- Able to meet strict, tight deadlines with a high level of accuracy.
- Able to prioritize multiple tasks.
- Able to work collaboratively with various levels of peers and management throughout the organization.
Licenses/Certifications Required Licenses/Certifications Preferred Required Training Physical Requirements Light Additional Information Salary Range
Disclaimer
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. 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)