Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-in…
Skills: Systems Configuration, Quality Assurance, User Acceptance Testing, Claims Processing, Analytical Skills
Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-inco…
Skills: Telesales, Customer Relationship Management (CRM), Interpersonal Skills, Microsoft Word, Microsoft Excel
Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-in…
Skills: SQL, SAS, Data Analysis, Healthcare Metrics, Quality Assurance
Salary Range: $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-i…
Skills: HEDIS Data Analysis, Survey Data Management, ETL Optimization, Staff Supervision, Data Validation
Community Resource Center Community Health Coordinator II
Los Angeles, California, United States · On-site
$50k–$75k/yr
Entry level
Salary Range: $50,216.00 (Min.) - $62,770.00 (Mid.) - $75,324.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-inco…
Skills: Community Outreach, Health Navigation, Cultural Mediation, Health Education, Motivational Interviewing
Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-in…
Skills: Critical Thinking, Problem Solving, Project Planning, Project Implementation, Writing
Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-in…
Skills: Process Improvement, Data Analysis, Project Management, Business Process Modeling, SWOT Analysis
Salary Range: $88,854.00 (Min.) - $115,509.00 (Mid.) - $142,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-in…
Skills: SQL, Tableau, Data Modeling, ETL, Multivariate Analysis
Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-in…
Skills: Project Management, Data Analysis, Regulatory Compliance, Healthcare Program Design, SPSS
Senior Business Manager, IT and Business Operations
Los Angeles, California, United States · On-site
$102k–$163k/yr
Senior
Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-i…
Skills: Program Management, Strategic Thinking, Financial Analysis, Budget Management, Process Improvement
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$77k–$124k/yr
Full-time
bachelor degree, postgraduate degree
Paid Time Off (PTO), Tuition Reimbursement, Retirement Plans, Medical Insurance, Dental Insurance, Vision Insurance
Posted 35d ago
~40 hrs/week
Responsibilities
The analyst supports integration and business process activities by performing technical testing, validation, and quality assurance of business requirements. They are responsible for recommending configuration improvements for the core system and managing all related QA documentation.
Requirements
Requires a Bachelor's degree in Business Administration or a related field and at least 5 years of experience in systems configuration or claims operations. Candidates must have advanced knowledge of Medicare/Medicaid rules and experience with QNXT or equivalent claims processing systems.
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
Job Summary
The Quality Configuration Assurance Analyst II supports integration and business process activities that utilize configuration by performing more complex technical and analytical work related to the testing, validation, and quality assurance of business requirements, including, but not limited to, managing and maintaining testing and quality assurance-related documentation and applying related industry best practices. This position is responsible for providing well thought-out recommendations for end-to-end business process and/or configuration improvements (as applicable, based on timely identification, analysis, and validation of opportunities for improvement) for the L.A. Care Health Plan core system and the related surround systems, applications, and databases (e.g., Clinical CareAdvance (CCA), Process Communication Tracking (PCT), Claims Test Pro, etc.).
Duties
Identify, analyze, and validate well thought-out recommendations for end-to-end business process and/or configuration improvements.
Manage and maintain testing and quality assurance-related documentation.
Interface and collaborate with peers within and outside the department and the organization to support configuration quality assurance best practices as well as business process and systems configuration improvements
Facilitate user acceptance test planning, test case specifications, test execution, peer reviews defect management, and test status reporting.
Perform other duties as assigned.
Duties Continued
Education Required
Bachelor's Degree in Business Administration or Related Field
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree in Business Administration or Related Field
Experience
Required:
At least 5 years of experience in a Systems Configuration, Claims or other Operations department.
Experience with identifying and analyzing the impact of systems configuration on business processes, other systems, and applications.
Advanced claims experience with QNXT or equivalent claims processing system.
Experience with Health Services/population health systems.
Quality Assurance experience in the health care industry.
Preferred:
At least 5 years experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management services organization.
Skills
Required:
Advanced knowledge of and experience with Medicare and Medicaid rules and regulations and related core and surround systems code and data sets, etc.
Strong communication, analytical, organizational, and time-management skills.
Ability to meet strict, tight deadlines with a high level of accuracy.
Ability to prioritize multiple tasks.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
Light
Additional Information
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Related keywords
QNXTClinical CareAdvanceProcess Communication TrackingClaims Test ProMedi-CalManaged Care PlanPopulation Health SystemsHealthcare IndustryUATConfiguration ManagementBusiness Process ImprovementPublic Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A. County’s low-income communities, and to support the safety net required to achieve that purpose. As a publicly operated health plan, L.A. Care Health Plan serves more than 2.6 million members in Los Angeles County, making it the largest publicly operated health plan in the country. L.A. Care offers four health coverage plans including Medi-Cal, L.A. Care Covered™, L.A. Care Medicare Plus and the PASC-SEIU Homecare Workers Health Care Plan, all dedicated to being accountable and responsive to members. L.A. Care prioritizes quality, access and inclusion, elevating health care for all of L.A. County. For more information, follow us on X, Facebook, LinkedIn, Instagram and YouTube.
To learn more, visit www.lacare.org.
*For urgent inquiries: 1-888-4LA-CARE (1-888-452-2273)
Offices: 1200 W 7th St, Los Angeles, California 90017, US
HMOHealth Information TechnologyHealthcare Insuranceand Community HealthHealth CareFitnessGovernment
L.A. Care’s mission is to provide access to quality health care for L.A. County’s low-income communities, and to support the safety net required to achieve that purpose. As a publicly operated health plan, L.A. Care Health Plan serves more than 2.6 million members in Los Angeles County, making it the largest publicly operated health plan in the country. L.A. Care offers four health coverage plans including Medi-Cal, L.A. Care Covered™, L.A. Care Medicare Plus and the PASC-SEIU Homecare Workers Health Care Plan, all dedicated to being accountable and responsive to members. L.A. Care prioritizes quality, access and inclusion, elevating health care for all of L.A. County. For more information, follow us on X, Facebook, LinkedIn, Instagram and YouTube.
To learn more, visit www.lacare.org.
*For urgent inquiries: 1-888-4LA-CARE (1-888-452-2273)
Offices: 1200 W 7th St, Los Angeles, California 90017, US
HMOHealth Information TechnologyHealthcare Insuranceand Community HealthHealth CareFitnessGovernment