L.A. Care Health Plan
Quality Configuration Assurance Analyst III
L.A. Care Health Plan, Los Angeles, California, United States, 90079
Quality Configuration Assurance Analyst III
Join to apply for the
Quality Configuration Assurance Analyst III
role at
L.A. Care Health Plan Quality Configuration Assurance Analyst III
1 day ago Be among the first 25 applicants Join to apply for the
Quality Configuration Assurance Analyst III
role at
L.A. Care Health Plan Get AI-powered advice on this job and more exclusive features. Salary Range:
$91,536.00 (Min.) - $121,286.00 (Mid.) - $151,034.00 (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 Quality Configuration Assurance Analyst III is responsible for the more complex technical and analytical work related to the testing, validation, and quality assurance of business requirements for and the configuration of the L.A. Care Health Plan Core System (i.e., QNXT) and the related surround systems, applications, and database (e.g., Clinical CareAdvance (CCA), Process Communication Tracking (PCT), etc.). The Quality Configuration Assurance Analyst III collaborates closely with peers and management within the department as well as throughout the organization to facilitate the timely, accurate quality assurance of the systems configuration; in-depth analysis of major factors, root causes, etc. that impact member access to care, claims payments, etc.; and assessment and roll-out of key measures to facilitate improvement, where warranted. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.
Duties
Identify, develop, and recommend new and/or enhanced testing specifications and related documentation. Serve as a subject matter expert for the quality assurance of the configuration of the core and surround systems. Perform the most complex quality audits of the systems configuration. Conduct thorough, in-depth root cause analysis to help identify issues and provide well thought-out recommendations for proposed business process and systems configuration improvements, where warranted.
Interface and collaborate with peers within and outside of the department and the organization to support quality assurance best practices, business process and systems configuration improvements, product enhancements, compliance with established turnaround times and service levels, etc.
Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.
Perform other duties as assigned.
Duties Continued
Education Required
Bachelor's Degree in Business or Related Field
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree in Business or Related Field
Experience
Required:
At least 5 years of experience in Systems Configuration; Claims and Health Services/Population Health department.
Advanced knowledge of and experience in health plan quality assurance (especially related to claims, health services/population health as well as appeals and grievances systems, applications, etc.)
Knowledge of and experience with utilizing SDLC and related change management methodologies, standards and best practices.
Preferred
At least 5 years of experience working with a California Medi-Cal managed care plan or Commercial health plan, medical group, or management services organization.
Skills
Required:
Advanced understanding of managed care operations (including but not limited to, claims processing, population health, appeals and grievances, etc.) and the systems that support these operations.
Knowledge of Systems Development Life Cycle (SDLC) procedures in planning the quality assurance (i.e., use of rigorous documentation, testing, and quality assurance protocols pre- and post-deployment).
Strong analytical, organization, and time management skills.
Able to meet strict, tight deadlines with a high level of accuracy.
Able 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)
Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
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Join to apply for the
Quality Configuration Assurance Analyst III
role at
L.A. Care Health Plan Quality Configuration Assurance Analyst III
1 day ago Be among the first 25 applicants Join to apply for the
Quality Configuration Assurance Analyst III
role at
L.A. Care Health Plan Get AI-powered advice on this job and more exclusive features. Salary Range:
$91,536.00 (Min.) - $121,286.00 (Mid.) - $151,034.00 (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 Quality Configuration Assurance Analyst III is responsible for the more complex technical and analytical work related to the testing, validation, and quality assurance of business requirements for and the configuration of the L.A. Care Health Plan Core System (i.e., QNXT) and the related surround systems, applications, and database (e.g., Clinical CareAdvance (CCA), Process Communication Tracking (PCT), etc.). The Quality Configuration Assurance Analyst III collaborates closely with peers and management within the department as well as throughout the organization to facilitate the timely, accurate quality assurance of the systems configuration; in-depth analysis of major factors, root causes, etc. that impact member access to care, claims payments, etc.; and assessment and roll-out of key measures to facilitate improvement, where warranted. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.
Duties
Identify, develop, and recommend new and/or enhanced testing specifications and related documentation. Serve as a subject matter expert for the quality assurance of the configuration of the core and surround systems. Perform the most complex quality audits of the systems configuration. Conduct thorough, in-depth root cause analysis to help identify issues and provide well thought-out recommendations for proposed business process and systems configuration improvements, where warranted.
Interface and collaborate with peers within and outside of the department and the organization to support quality assurance best practices, business process and systems configuration improvements, product enhancements, compliance with established turnaround times and service levels, etc.
Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project’s/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Provides training, recommends process improvements, and mentors junior level staff, department interns, etc. as needed.
Perform other duties as assigned.
Duties Continued
Education Required
Bachelor's Degree in Business or Related Field
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree in Business or Related Field
Experience
Required:
At least 5 years of experience in Systems Configuration; Claims and Health Services/Population Health department.
Advanced knowledge of and experience in health plan quality assurance (especially related to claims, health services/population health as well as appeals and grievances systems, applications, etc.)
Knowledge of and experience with utilizing SDLC and related change management methodologies, standards and best practices.
Preferred
At least 5 years of experience working with a California Medi-Cal managed care plan or Commercial health plan, medical group, or management services organization.
Skills
Required:
Advanced understanding of managed care operations (including but not limited to, claims processing, population health, appeals and grievances, etc.) and the systems that support these operations.
Knowledge of Systems Development Life Cycle (SDLC) procedures in planning the quality assurance (i.e., use of rigorous documentation, testing, and quality assurance protocols pre- and post-deployment).
Strong analytical, organization, and time management skills.
Able to meet strict, tight deadlines with a high level of accuracy.
Able 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)
Seniority level
Seniority level Mid-Senior level Employment type
Employment type Full-time Job function
Job function Quality Assurance Industries Hospitals and Health Care Referrals increase your chances of interviewing at L.A. Care Health Plan by 2x Get notified about new Quality Assurance Analyst jobs in
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