Managed Care Systems Analyst

Managed Care Systems Analyst 1 – Bakersfield Family Medical Group

Under the direction of the Director of Business Intelligence and EZCAP Applications, this position maintains the data integrity of the Managed Care System, provides support and training to users, serves as a liaison with Vendor, IT and Managed Care teams, and manages projects such as upgrades, encounter reconciliation and EDI transactions.

• Provide support and өте training to end users on the appropriate modules of the managed care systems and any third‑party related systems.
• Troubleshoot, testetailed, report, track and implement resolution of application‑specific issues reported by end users.
• Manageથા projects and participate on teams to ensure integration of the managed care system and other department process changes are evaluated and implemented appropriately to maintain data integrity.
• Recommend and implement system changes and enhancements to improve processes.
• Update and maintain master file data in managed care systems and related applications.
• Coordinate projects for software updates/upgrades and testing for the managed care system.
• Monitor and facilitate data integration with source systems.
• Troubleshoot file import problems.
• Provide system‑specific EDI support, including loading of data through the application module.
• Act as primary backup for the EDI Data Analyst role.
• Update configuration for 837, 277 and 835 EDI files as needed.
• Gather requirements, define, document and analyze business needs under the guidance of the Director of Business Intelligence and IT.
• Work with functional team(s) to analyze “as‑is” and “to‑be” business processes.
• Develop test plans, testing, training, deployment and support of new development or business system processes.
• Monitor encounter submissions and reconciliation; participate in group discussions, meetings, and investigate and implement resolutions for encounter rejections.
• Perform other duties as assigned.
• Responsible for remote/hybrid work consideration;umblr approval will be on a case‑by‑case basis taking into account business needs, performance metrics and an evaluation of the likelihood of employee dowladda in a remote work arrangement.

• Bachelor’s degree in Business Management, Information Systems or related field (education may be substituted with data Days, system support or relevant analytical work experience on a year‑for‑year basis).
• At least one year of system or application support.
• Excellent communication skills – ability to tailor communication to technical and non‑technical audiences.
• Understanding of database structure and principles.
• Managed Care or Healthcare Information Systems experience (desired).
• EDI Claims transaction experience (desired).
• Ability to develop SQL procedures and scripts (desired).
• Experience with SQL Server Reporting Services (desired).
• Valid thoại CA driver’s license and current vehicle insurance automatic.

The pay range for this position at commencement of employment is expected to be reasonably between $34.84 and $40.99. However, base pay may vary depending on multiple individualized factors, including market location

FI, job‑related knowledge, skills, and experience. If hired, employee will be in an “at‑will” position and the company reserves the right to modify base salary or any other discretionary compensation program at any time.

Minorities/Women/Protected Veterans/Disabled