Analyst II - Product System Configuration
Company: Inland Empire Health Plan
Location: Rancho Cucamonga
Posted on: April 22, 2024
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Job Description:
What you can expect!Find joy in serving others with IEHP! We
welcome you to join us in healing and inspiring the human spirit
and to pivot from a job opportunity to an authentic
experience!Under the direction of the Supervisor of Product System
Configuration, the Analyst II Product System Configuration is
responsible for managing the more complex system configurations
within the Business System. The primary functions of this position
include but are not limited to, accurate interpretation of state,
federal, and contractual guidelines related to benefits, fee
schedules, contracts, division of financial responsibility (DOFR),
codification of services, and business requirements and translating
them into configurable parameters within the Business Systems. The
Analyst II Product System Configuration is independent and acts as
a subject matter expert for the business areas by helping to drive
decisions related to system configuration. The incumbent will
develop and maintain comprehensive documentation of business and
technical specification requirements utilizing best practice
configuration guidelines developed by the Application Architects
within the unit. The Analyst II Product System Configuration will
facilitate communication and formally report findings to various
department heads and staff in a manner that is appropriate to the
skill level and technical expertise of the audience. This position
will be required to train and help educate other team members
within the unit as necessary.PerksIEHP is not only committed to
healing and inspiring the human spirit of our Members; we also aim
to match our Team Members with the same energy by providing prime
benefits and more.CalPERS retirement457(b) option with a
contribution matchGenerous paid time off- vacation, holidays,
sickState of the art fitness center on-siteMedical Insurance with
Dental and VisionPaid life insurance for employees with additional
optionsShort-term, and long-term disability optionsPet care
insuranceFlexible Spending Account Health Care/ChildcareWellness
programs that promote a healthy work-life balanceCareer advancement
opportunities and professional developmentCompetitive salary with
annual merit increaseTeam bonus opportunitiesEducation &
ExperienceFour (4) years of experience with the development and
remediation of moderately complex system configurations, including
capitated provider agreement configurationsBachelors degree from an
accredited institution requiredIn lieu of the required degree, a
minimum of four (4) years of additional relevant work experience is
required for this positiontwo (2) years of general healthcare
experience plus two (2) years of configuration experience is
requiredKey QualificationsKnowledge of Medicare and Medi-Cal fee
schedules and benefit structure, and regulatory billing guidelines
requiredKnowledge of CMS, DHCS, DMHC, NCQA rules and regulations
preferredExtensive knowledge of CPT, HCPCS, Revenue, ICD10 coding
rules and guidelines preferredExtensive knowledge of general
managed care operations required; delegated plan model
preferredBasic knowledge of relational database structureAdvanced
knowledge of Product System algorithms and processes
preferredFamiliar with basic medical product processing preferredby
Jobble
Keywords: Inland Empire Health Plan, Rancho Cucamonga , Analyst II - Product System Configuration, Professions , Rancho Cucamonga, California
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