• Care1st Health Plan
  • Santa Ana, CA
  • Telecommuting/Work-At-Home
  • Full-Time
  • 2813 W Harvard St

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Provides solution design, data analysis support, testing and hands-on configuration of the Trizetto Healthcare Products applications This includes effectively implementing new application capabilities and subsequently assuming on-going operational responsibility for enhancing and maintenance of the applications. Works with business process leaders to translate new business requirements and processes into package requirements and subsequent effective configuration. Applies professional principals and techniques to standard work assignments but seeks guidance on more complex work.

Hands on configuration/implementation knowledge of core benefit administration package software (e.g., Facets, Networx, Elements) or hands on subject matter expertise in Blue Plan operational processes. Strong understanding of claim processing, installation and billing or product benefit structures medical product is a plus.

  • Analyze medium to hard customers business requirements and software/product objectives and perform system configuration analysis, design, coding, and unit testing following established processes, standards and procedures.
  • Development of prototype configuration to support solution selection and develop documented solutions and processes using appropriate documentation protocols.
  • Resolve escalated issues in the appropriate manner and appropriate timeframe, to meet client specific SLAs.
  • Identifying gaps between external expectations and system limitations and suggest configuration improvements or streamlined maintenance processes and techniques.
  • Estimate time frames, quality and quantity of resources required to successfully complete activities.
  • Provide periodic status checks on all project activities to clients and internal teams, to assess progress against project plan.
  • Providing regular and concise status reports to clients and direct manager.
  • Ensure traceability of configuration solutions back to performance goals and metrics.
  • Act as the liaison between IT and business areas in support of extensions and service packs.
  • Other duties as assigned

  • Qualifications

    Job Required Education/Experience
  • 2-4 years performing complex business &/or technology operations including experience with healthcarebenefits (such as Medicare Advantage, Medicare Supplemental, HMO, PPO products) or 4+ years claims processing and/or member installation and billing experience
  • Strong written and verbal communication skills
  • Demonstrated advanced competence with MS Word and Excel.
  • Strong understanding of database concepts and competence with MS Access/SQL Developer are preferred
  • Physical RequirementsOffice Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork Activity level: Sedentary, frequency most of work day.

    * The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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