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 in five health plans, 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 II supports integration and business process activities that utilize configuration by performing more complex technical and analytical work related to the testing, validation, and quality assurance of business requirements, including, but not limited to, managing and maintaining testing and quality assurance-related documentation and applying related industry best practices. This position is responsible for providing well thought-out recommendations for end-to-end business process and/or configuration improvements (as applicable, based on timely identification, analysis, and validation of opportunities for improvement) for the L.A. Care Health Plan core system and the related surround systems, applications, and databases (e.g., Clinical CareAdvance (CCA), Process Communication Tracking (PCT), Claims Test Pro, etc.).
Duties
Identify, analyze, and validate well thought-out recommendations for end-to-end business process and/or configuration improvements.
Manage and maintain testing and quality assurance-related documentation.
Interface and collaborate with peers within and outside the department and the organization to support configuration quality assurance best practices as well as business process and systems configuration improvements
Facilitate user acceptance test planning, test case specifications, test execution, peer reviews defect management, and test status reporting.
Perform other duties as assigned.
Duties Continued
Education Required
Bachelor's Degree in Business Administration or Related Field
In lieu of degree, equivalent education and/or experience may be considered.
Education Preferred
Master's Degree in Business Administration or Related Field
Experience
Required:
At least 5 years of experience in a Systems Configuration, Claims or other Operations department.
Experience with identifying and analyzing the impact of systems configuration on business processes, other systems, and applications.
Advanced claims experience with QNXT or equivalent claims processing system.
Experience with Health Services/population health systems.
Quality Assurance experience in the health care industry.
Preferred:
At least 5 years experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management services organization.
Skills
Required:
Advanced knowledge of and experience with Medicare and Medicaid rules and regulations and related core and surround systems code and data sets, etc.
Strong communication, analytical, organizational, and time-management skills.
Ability to meet strict, tight deadlines with a high level of accuracy.
Ability 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)