Application Coordinator

Nexlogica; California (MO); On-site; USD 60,000 - 80,000; Full time

Job summary

Nexlogica is seeking a candidate for Epic application support and lifecycle management in Missouri. The successful applicant will analyze user needs, provide direct support, and ensure system stabilization, contributing to healthcare solutions.

The role requires experience in project management and familiarity with healthcare standards. A minimum of one year in application support and a bachelor’s degree in an IT-related field are essential.

Qualifications

• Minimum 1 year of application support/build/configuration experience in a health plan.
• Experience in a healthcare setting is preferred.

Responsibilities

• Provide direct Epic application support and software lifecycle management.
• Analyze user and application needs to determine solutions.
• Monitor and maintain system stabilization.

Skills

Business analysis

Project management

Epic implementation

Healthcare regulatory standards

Case management workflows

Quality reporting initiatives

AP Claims operations

Care plan usage

Managed care contracting

Education

Bachelor's degree in IT-related or Engineering field

Tools

Health Planet Analytics and Clinical Build

Epic Care Link

Job description

Position Description

Candidate will provide direct Epic application support and Epic software development lifecycle for the design, development, monitoring, testing, updating, integration, and maintenance of system stabilization.

Candidate will analyze user, system, and application needs and will evaluate approaches to determine the best solution to meet VHP’s business needs via performance of the defined itemization of responsibilities above and below.

Skills Required

• Experience in business analysis and project management
• Knowledge of healthcare and health insurance regulatory standards
• Epic implementation experience specifically at a health plan
• Understanding relationships of providers and their processes in the healthcare continuum (primary care, specialists, lab ordering, surgery)
• Familiarity with case management workflows and wellness programs. Familiarity with or background in quality reporting initiatives such as PQRS, ACOs/MSSP, and MU.
• Familiarity with health plan concepts and workflows
• Understanding of operations within the AP Claims department, including claim intake, review, and payment.
• Familiarity with integration points with other areas of business, such as eligibility, authorizations, and internal claims.
• Familiarity with the benefit structures of plans.
• Familiarity with the use of care plans to coordinate care for members/patients.
• Familiarity with managed care contracting.
• Understanding of treatment authorization policies/processes that affect approvals or denials and the concepts of treatment referrals and the processes followed.

Experience Required

A minimum of 1 year of application support/build/configuration and/or related business/operational experience in a health plan or health care setting.

Education Required

Possession of a bachelor’s degree in an IT-related or Engineering field.

Certification / Training

• Health Planet Analytics and Clinical Build
• Epic Care Link