About this role
Salary Range: $105,267.00 (Min.) - $139,478.00 (Mid.) - $173,689.00 (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-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 Lead Systems Configuration Technical Analyst is responsible for managing complex system configurations, health plan implementations and conversions within the Core Configuration team. Primary responsibilities include the accurate interpretation of specific state/federal and/or business requirements and the impact to the various system modules to convert them into configuration parameters within the core system(s).
The Lead will support integration and business process activities that utilize configuration as part of the end-to-end solution to meet business requirements. This position will identify opportunities for improvement, as well as be able to suggest ways to bridge the gap between inter-dependent departments.
The Lead will triage possible issues identified and implement applicable remediation to address confirmed configuration issues. This position will redesign complex business concepts resulting to correct processing conflicts. The position will work with and mentor people of various professional, vocational, and educational backgrounds. This position will be responsible for the daily workflow and leading the work of assigned staff. This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.
Duties
Implementing complex system configuration changes to the managed care core system. Evaluating, testing, and validating configuration changes ensuring they meet service levels and quality standards. Ensuring completeness of requirements for the design and implementation of system business solutions. Triaging system issues and implementing applicable remediation to resolve issues.
Developing solutions to resolve problems and making recommendations for improvements to process, configuration and products. Developing complex business requirement specifications to complete configuration analysis and design. Analyzing user requirements, evaluating functionality and configuration options available to improve business results.
Mentoring and training team members, providing guidance and solutions to system users and technical resources. Providing technical advice on business impact and opportunities. Creating and developing training documentation and presentations.
Attending and collaborating cross-functional meetings to develop, document and present system solutions. Lead the translation of business requirements into configuration requirements. Lead the formulation and definition of system scope and objective based on users’ needs and understanding of business processes. Participating in solution design by preparing and evaluating alternative solutions. Developing and presenting proposals for modifications.
Managing complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.
Lead the work of assigned staff; regularly assigns and checks the work of others, providing guidance, training and feedback on performance to department management. Overseeing the daily office workflow, develops and recommends enhancements to process and procedures.
Perform other duties as assigned.
Duties Continued
Education Required
Education Preferred
Experience
Required:
At least 5 years of experience in benefit, contract configuration and product interpretations in a healthcare/ health plan environment with 5 years of claims experience and 3 years in medical coding initiatives and guidelines.
Minimum of 3 years of lead experience (process, program, or staff).
Skills
Required:
Expert level of knowledge of QNXT.
Requires excellent analytical, organization and communication skills.
Requires in-depth knowledge of system analysis and configuration.
Able to breakdown raw information and undefined problems into specific, workable components that in-turn clearly identifies the issues at hand.
Ability to understand a customer's business needs and translate needs into specific requirements.
Ability to plan and account for configuration impacts across business processes and applications.
Demonstrated ability to collaborate with other members of formal and informal groups in the pursuit of common missions, vision, values and mutual goals.
Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
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)
Other facts
About L.A. Care 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)
What you'll do
- The Lead Systems Configuration Technical Analyst manages complex system configurations and health plan implementations. They triage issues, implement remediation, and mentor team members while ensuring quality standards are met.
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