Senior Business Systems Analyst

2 months ago

San Francisco, California, United States Inland Empire Health Plan Full time
About the Role

We are seeking a highly skilled and experienced Senior Business Systems Analyst to join our team at Inland Empire Health Plan. As a key member of our team, you will be responsible for managing complex system configurations within our Business System.

Key Responsibilities
  • Configuration Management: Develop and maintain comprehensive documentation of business and technical specification requirements utilizing best practice configuration guidelines.
  • System Analysis: Analyze and translate business specifications into detailed technical specifications based on system functionality and develop non-systematic workaround processes when necessary.
  • Error Root Cause Analysis: Perform product system error root cause analysis to identify and resolve issues.
  • Request Tracking: Track incoming requests and issue resolution through Microsoft Access, MediTrac, and Workfront tools.
  • System Impact Assessment: Identify and communicate the impact of system enhancements or configuration changes on integrated systems and processes.
  • System Configuration Inventory: Monitor and work daily System Configuration inventory and ensure compliance with established service level agreements and regulatory timelines.
  • System Builds: Configure and maintain complex product related system builds with multi-tiered functionality and interrelated system dependencies.
  • Contracting Support: Assist Contracting team with drafting appropriate contract fee schedule language to be in line with system adjudication capabilities and coding standards.
  • Business Requirements: Develop and maintain business requirements for the automation of coding updates.
  • System Testing: Track, test, and approve new system functionality, enhancements, and bug fixes, including the development and execution of test plans and scripts.
  • System Audits: Perform weekly/bi-weekly audit of check run products to proactively identify potential system configuration issues before products are released.
Requirements
  • Experience: Four (4) years of experience with the development and remediation of moderately complex system configurations, including capitated provider agreement configurations.
  • Education: Bachelor's degree from an accredited institution required.
  • Knowledge: Knowledge of Medicare and Medi-Cal fee schedules and benefit structure, and regulatory billing guidelines required.
  • Skills: Extensive knowledge of CPT, HCPCS, Revenue, ICD10 coding rules and guidelines preferred.
Perks
  • CalPERS Retirement: Eligible for CalPERS retirement plan.
  • 457(b) Option: Eligible for 457(b) option with a contribution match.
  • Paid Time Off: Generous paid time off, including vacation, holidays, and sick leave.
  • Medical Insurance: Comprehensive medical insurance with dental and vision coverage.
  • Pet Care Insurance: Eligible for pet care insurance.
  • Flexible Spending Account: Eligible for Flexible Spending Account - Health Care/Childcare.
  • Wellness Programs: Participate in wellness programs that promote a healthy work-life balance.

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