Managed Care Systems Analyst 1
Bakersfield Family Medical Group is seeking a Managed Care Systems Analyst 1 to maintain the data integrity of the Managed Care System and provide support and training to users. The role involves managing projects, troubleshooting application issues, and serving as a liaison between various departments and vendors.
Responsibilities
- 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
Skills
- 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
- At least 1 year of system or application support
- Excellent communication skills - ability to tailor communication to audience (technical and non-technical)
- Understanding of database structure and principles
- Valid CA Driver's License and current vehicle insurance
- Managed Care / Healthcare Information Systems experience
- EDI Claims transaction experience
- Ability to develop SQL procedures and scripts
- Experience with SQL Server Report Services
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