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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