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Rancho Cucamonga

    Supervisor, Product System Configuration - Rancho Cucamonga, United States - Inland Empire Health Plan

    Inland Empire Health Plan
    Inland Empire Health Plan Rancho Cucamonga, United States

    3 weeks ago

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    Description

    Overview:

    What you can expect

    Find joy in serving others with IEHP We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience

    Under the direction of the Product System Configuration Manager, the Supervisor, Product System Configuration will lead a team of Configuration Analysts and Coders is responsible for managing the more complex system configurations within the Product System. The incumbent will directly supervise multiple analysts and oversee the day-to-day operations, including the delegation of duties, assignments, and projects to maintain timelines and inventory. The primary functions of this position include but are not limited to, enhancing efficiency and automation by developing new features and functionality to the Product System, codification of benefits, contracts, and the division of financial responsibility (DOFR), and translating business requirements into configurable technical specifications for the Business Systems. The Supervisor is independent and acts as a subject matter expert for the business areas and the Product Configuration team by leading the efforts related to complex system configuration. The incumbent will contribute to the system build efforts as well as maintain comprehensive documentation of business and technical specification requirements. The Supervisor will facilitate communication and formally report findings to various department heads and Chiefs in a manner that is appropriate to the skill level and technical expertise of the audience.

    Major Functions (Duties and Responsibilities)

    1. Configure and maintain complex product related system builds with multi-tiered functionality and interrelated system dependencies, including but not limited to Contracts, Benefits, Service Categories, Special Match Rules, Fee Schedules, and Modifier Reduction schedules
    2. Responsible for tracking, testing, and approving new system functionality, enhancements, and defect fixes, including the development and execution of test plans and scripts
    3. Manage daily activities, tasks, and processes for the Product System Configuration team
    4. Develop and document configuration standards and best practice guides for maintaining efficiency, accuracy, automation and successful integration with internal and external systems and programs
    5. Design and facilitate system training and development for configuration staff
    6. Analyze and translate business specifications into detailed technical specifications based on system functionality and develop non-systematic workaround processes when necessary
    7. Monitor mechanisms used for internal tracking of incoming requests and issue resolution, new development and system enhancement needs, and ensure staff compliance with tracking requirements outlined by the department
    8. Monitor daily inventory and ensure compliance with established service level agreements and regulatory timelines
    9. Assist Contracting team with drafting appropriate contract fee schedule language to be in line with system adjudication capabilities
    10. Develop and maintain internal policies and procedures for Product System Configuration activities and processes
    11. Establish minimum standards and skill sets for staffing and ensure that substandard performance is appropriately and formally addressed
    12. Ensure work-from-home staff work tracking logs are completed accurately and in a timely manner
    13. Maintain process for quality assurance review of completed configuration to ensure that business and technical specifications are met and do not produce any unexpected and/or undesirable outcomes
    14. Apply LEAN/A3 methodologies to business process and system configuration design and development
    15. Other duties as assigned, including but not limited to Department Projects and LEAN/A3 Events

    Commitment to Quality: The IEHP Team is committed to incorporate IEHPs Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

    Additional Benefits:

    Perks

    IEHP is not only committed to healing and inspiring the human spirit of our Members; we also aim to match our Team Members with the same energy by providing prime benefits and more.

    • CalPERS retirement
    • 457(b) option with a contribution match
    • Generous paid time off- vacation, holidays, sick
    • State of the art fitness center on-site
    • Medical Insurance with Dental and Vision
    • Paid life insurance for employees with additional options
    • Short-term, and long-term disability options
    • Pet care insurance
    • Flexible Spending Account Health Care/Childcare
    • Wellness programs that promote a healthy work-life balance
    • Career advancement opportunities and professional development
    • Competitive salary with annual merit increase
    • Team bonus opportunities
    Qualifications:

    Education & Experience

    • Five (5) years of extensive configuration, coding, and/or provider contracting experience including capitated agreement configurations
    • Supervisory experience required
    • Bachelors degree from an accredited institution required
    • In lieu of the required degree, a minimum of eight (8) years of additional general healthcare experience and configuration, coding, and/or provider contracting is required for this position
    • This experience is in addition to the minimum years listed in the Experience Requirements above

    Key Qualifications

    • Proficient in Microsoft Excel and Access preferred
    • Strong presentation and written communication skills
    • Strong leadership and interpersonal skills
    • Strong critical thinking and problem-solving skills required

    Start your journey towards a thriving future with IEHP and apply TODAY

    Pay Range:
    USD $ USD $66.27 /Hr.
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