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Director of Configuration

3 months ago

French Camp, United States SAN JOAQUIN COUNTY HEALTH COMMISSION Full time
Job DescriptionJob Description

The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

Remote: Must reside in California.


Our Vision:

Continuously improve the health of our community.

Our Mission:

We provide healthcare value and advance wellness through community partnerships.


What You Will Be Doing:

Under general supervision responsible for providing strategic direction, system configuration development and managing the daily activities of healthcare related configuration efforts according to best practice, internal and external requirements, and in support of organizational strategy. Work is varied and complex and requires a moderate to high degree of discretion and independent judgment.

Supervises

  • Manager, Configuration and Configuration Analysts.

Essential Functions

  • Identifies, develops, plans and executes strategies, collaborating with peers and others to ensure effective integration; oversees the development and implementation of department goals and actions plans.
  • Monitors system performance and take appropriate action.
  • Collaborates with internal stakeholders to ensure systems are configured appropriately and consistent with Medi-Cal and contract requirements
  • Develops and executes improvements to department workflows.
  • Oversees projects and monitors performance, evaluates priority level and makes changes as necessary; provides overall project support for planning, implementation, testing, and coordination of configuration related projects.
  • Meets with direct reports to review project and program status on a routine basis, provides feedback and guidance where appropriate.
  • Develops tools and standard processes to track and measure the achievement of project-based goals and objectives.
  • Reviews and approves completed system changes and enhancement work plans received from the configuration staff to ensure compliance with project approval and specifications.
  • Develops or oversees the development of policies and procedures to achieve integration of various system-related configuration; ensures that subordinate managers develop and implement appropriate companion procedures.
  • Oversees the development and implementation of training programs and plans to ensure systems are configured for optimal performance.
  • Oversees the development and implementation of audit programs.
  • Reviews and provides direction related to DMHC, DHCS APLs/ OILs, Medi-Cal policy updates to implement system changes required to ensure compliance with requirements.
  • Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.
  • Hires, develops, supervises and retains, and ensures direct reports hire, develop, supervise and maintain, an adequate and competent staff.

What You Bring:

Knowledge, Skills and Abilities

  • In-depth knowledge of the principles and practices of the managed health care systems and medical administration.
  • In-depth knowledge of the healthcare and managed care industry, its products, services and major business processes.
  • In-depth knowledge of Medi-Cal contract rules, regulations, benefits and reporting.
  • In-depth knowledge of the rules and guidelines related to delegated relationships.
  • Strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.
  • Strong skills at considering different viewpoints and understanding the implications of each for the customer, for the business and for all its units.
  • Financial acumen: Interprets and applies understanding of key financial indicators to make better business decisions.
  • Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies.
  • Drives results: Consistently achieves results, even under tough circumstances.
  • Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.
  • Decision quality: Makes good and timely decisions that keep the organization moving forward.
  • Builds networks: Effectively builds formal and informal relationship networks inside and outside of the organization
  • Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.
  • Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.
  • Ensures accountability: Holds self and others accountable to meet commitments.
  • Persuades: Uses compelling arguments to gain the support and commitment of others.
  • Manages ambiguity: Operates effectively, even when things are not certain, or the way forward is not
  • Organizational savvy: Maneuvers comfortably through complex policy, process and people.
  • Collaborates: Builds partnerships and works collaboratively with others to meet shared objectives.
  • Strong interpersonal skills with the ability to initiate establish and maintain effective working relationships with diverse individuals both inside and outside of HPSJ.
  • Strong oral and written communication skills with the ability to communicate professionally, effectively and persuasively to diverse individuals and groups inside and outside of HPSJ; includes the ability to effectively explain complex information.
  • Strong presentation skills, including the ability to tailor presentations to a specific audience, and address and interact with large groups.
  • Strong project management skills, including the ability to manage organizational-wide projects to successful conclusion.
  • Demonstrated ability to articulate and support HPSJ’s vision, mission, values and strategy, integrate into management practices, and foster their manifestation among staff.
  • Ability to supervise staff, and ensure that direct reports supervise staff, in a manner that maximizes employee performance and business results.
  • Intermediate skills in Word, Excel and Outlook, including the ability to develop spreadsheets, formulas, and create tables and graphs.
  • Ability to speak and be understood in English
  • Ability to handle confidential information with appropriate discretion.

What You Have:

Education and Experience

Required

  • Bachelor’s Degree in related field; and
  • At least five years of experience analyzing and enhancing automated claims systems in a managed care environment; and
  • At least five years of management experience in a configuration environment; and
  • At least three years of relevant project management experience, preferably in a managed care/healthcare environment; or
  • Equivalent combination of education and/or experience.

License, Certification, Registration

  • Valid California driver license and reliable transportation or, the ability to obtain transportation on demand in the counties served by HPSJ if prohibited from getting a driver license due to a medically documented disability.

What You Will Get:

HPSJ Perks:

  • Competitive salary
  • Robust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers
  • Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
  • CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
  • Two flexible spending accounts (FSAs)
  • Employer-Paid Term Life and AD&D Insurance
  • Employer-Paid Disability Insurance
  • Employer-Paid Life Assistance Program
  • Health Advocacy
  • Supplemental medical, legal, identity theft protection
  • Access to exclusive discount mall
  • Education and training reimbursement in addition to employer-paid elective learning courses.
  • A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
  • A shorter commute ­– if you’re commuting from the Central Valley to the Bay Area.
  • Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.


We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.

HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics.

Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.