Operations Systems Analyst I - Provider Configuration

 
Position: Operations Systems Analyst I - Provider Configuration

Location: US-TX-Bellaire

Talent Area: Professional - Non-Clinical

Shift: 8a-5p

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.   To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.   Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for an Operations Systems Analyst - Provider Configuration - someone who works well in a fast-paced setting. In this position, you will be responsible for the activities related to minor system updates, new health plan implementations and conversions within the Business Operations teams.

 

This role will be responsible for provider configuration through our payor systems. Someone with experrience in Managed Care configuration through QNXT, Tapestry, or other Health Plan Payor systems is preferred. Previous experience with claims in Managed Care - Medicaid or Commercial is also preferred.

 

Think you’ve got what it takes?



Responsibilities :

  • Performs daily review of business applications functions
  • Maintains thorough and concise documentation for tracking of all provider, contract, benefit or Process Director changes related to Change Control Management or issues for quality audit purposes
  • Supports the applications installation through the implementation cycle
  • Reviews and tests systems for conformance to functional and performance requirements
  • Performs configuration analysis for system design associated with small and less complex projects
  • Analyzes by applying knowledge and experience to ensure appropriate information has been provided
  • Analyzes system problems and modifications
  • Coordinates implementation and upgrades of systems


Qualifications:

  • High school diploma or GED required
  • Bachelor’s degree in computer science, business administration, healthcare administration or related field preferred
  • Two years’ health plan payor information systems experience required
  • A bachelor’s degree may substitute for the two years of required work experience


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