Duties:

Provides medium- to high-level support and expertise related to systems configuration, research and analysis, and State policy and procedure implementation, in support of the Application Analyst IV – Core Systems, with duties including but not limited to:

• Assisting with the integration process of new vendors

• Performing troubleshooting and resolving issues pertaining to core systems, as well as internal development and integrations

• Supporting the Application Analyst IV – Core Systems by gathering information related to issues with core systems and providing recommendations regarding resolution of issues

• Assisting in cross-functional tasks/projects while achieving timely and accurate deliverables

• Supporting internal customers with workflow analysis related to core systems

• Providing input on the development and implementation of administrative policies, processes and procedures related to Application Services Department operations

• Supporting the Application Analyst IV – Core Systems and Application Services leadership by participating in the design, development, testing, and implementation of internal Tactical Plan projects, operations and reporting solutions

• Assisting with assessing software bugs and change requests in order to support the Application Analyst IV – Core Systems and Application Services leadership in prioritizing with stakeholders, internal development, and vendors

• Supporting generation of routine operational and system reports for Application Services leadership, subject to peer review

• Assisting the Application Analyst IV – Core Systems with the assessment and interpretation of policy and operational changes from the Department of Health Care Services (DHCS), Department of Managed Health Care (DMHC), Centers for Medicare and Medicaid Services (CMS) and other governmental entitie

Requirements

• Bachelor’s degree in Business Administration, Health Care, Information Technology, Information Science, or a related field

• 5+ years (or a Master’s degree and three years) of product configuration, provider payments, and member benefits experience which included some experience related to training staff

• 3+ years of experience in a managed health care environment; or an equivalent combination of education and experience may be qualifying

• Experience with D-SNP highly desired.

• Thorough knowledge of the Medicaid Program, the methods of product configuration in a Medicaid/Medicare environment, and the medical terminology, related procedures, and national diagnostic coding

• Working knowledge of: health care regulatory policies, principles of health care planning and administration, health care data analytics, State and Federal Legislative processes, and Medi-Cal.

• Experience with HSP/Meditrac claims processing systems and ancillary systems

• Experience working with methodologies such as Application Lifecycle Management and various project management methodologies and best practices desired

• Some knowledge of Agile/Scrum development environments desired

• Proficiency in the use of SharePoint desired