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Job ID: 4956

           Sr. Systems Analyst

 

Location: Camarillo, CA 93010

Contract: Long-term project (1 – 2 years)

Interview Process: Phone/Skype + Onsite

Must Have*

  • Strong Analytical & Technical skills, understanding of development
  • Must be able to understand what the business requirements are and then provide solutions design
  • Must have critical thinking experience, technical configuration, Regulatory, HIPAA, and MUST have Claims Processing experience. 
  • Currently using IKA Claims system and moving over to VBA Claims System, (Any strong Claims Systems Exp is fine)
  • Must have excellent communication skills – must be comfortable working in a small environment – needs hands-on individual. 
  • Strong written, verbal skills, even tempered and a collaborative team player a must.

Overview

BSA will work on the Company Provider Data Management Optimization (PDMO) program of work.  This work is currently underway with one full time in-house BSA resource and a full-time in-house developer. There are three projects involved in this program of work:

  • SB137 (Provider Directories)
  • Managed Care Provider Data Improvement / HIPAA 274 Transaction Set (MCPDIP)
  • Provider Data Process Improvement.  

Overall program objectives are compliance with regulatory initiatives MCPDIP and SB137, enhancement of GCHP’s provider data submission to CA State agency DHCS along with replacement of the APL 14006 file submission, provider data clean up with provider system process improvement, and improved HEDIS reporting.  Assigned work may also include participation in RFP.

 

Our current HEDIS solution is Inovalon SaaS. We use IKA claims. MedHOK SaaS medical management system; and a home-grown custom provider network database with MS-Access front end & MS-SQL Server database backend.  We also have home-grown data marts consisting of data extracted from our various business applications (primarily SaaS and hosted).

Desirable Knowledge, Skills, & Abilities

  • include those in the job description below plus to emphasize SQL, HIPAA, EDI, ERDs/database table structure/normalization, SDLC end-to-end experience, software implementation experience, business/functional/technical requirements, specs, and solution design. Managed care & provider/provider network data experience. Systems integration/interface experience, testing experience supporting unit, system, regression, integration test cycles with test case development/review/approval/execution.  Solution architecture & design with formal documentation, gap analysis, policy & procedure development, production support, process engineering, UAT support, RCA experience, system configuration.  
  • Provides analytical support for systems projects, including business function support for system migrations and consolidations, business area process improvement projects, and product installations
  • Consults with business to identify and document current operational procedures, problems, system input and output requirements, data scope, functional usage, formatting, user screen layout design, workflows and security requirements.
  • Leads system requirements definition, design, testing, training and implementation support. Applies use of tools to define requirements and documentation.
  • Writes and maintains functional specifications for new or modified business systems.
  • Consults with programmers to design and develop automated business tools.
  • Communicates business requirements and technical specifications to programming/development resources.
  • Assists business in the creation of user documentation, instructions, and procedures.
  • Documents and monitors post-implementation issues and coordinates through resolution.
  • Develops and/or reviews departmental business system requirements and business systems design documents, customer acceptance test plans, and post-implementation plans.
  • Works with external technology partners in implementing new reporting capabilities, systems enhancements and technology.
  • Provides analysis of efficiencies related to system enhancements/automation.
  • Develops use cases and test cases. Executes system testing.
  • Leads user acceptance testing.

 Qualifications

  • Systems Analysis – Ability to determine how a system should work and how changes in conditions, operations, and the environment will affect outcomes.
  • Technical Aptitude – Ability to comprehend complex technical topics and specialized information.
  • Project Management – Ability to organize and direct a project to completion.
  • Problem Solving – Ability to find a solution for or to deal proactively with work-related problems.
  • Business Acumen – Ability to grasp and understand business concepts and issues.
  • Relationship Building – Ability to effectively build relationships with customers and co-workers.

Education & Expertise

  • Bachelor's Degree (four-year college or technical school) Required, Field of Study: Information Systems, Finance/Accounting, Business or other technical/analytical field.
  • Or any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.
  • 8 plus years of progressive experience in analytical and data processing with experience on larger scale, complex initiatives/projects.
  • Managed Health Care industry experienced required.
  • Proficient in Word, Excel, Access, Project, Visio, SharePoint and Windows operating systems.

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