Quality Configuration Assurance Analyst III

L.A. Care Health Plan; Los Angeles (CA); Sur place; USD 92 000 - 151 000; Plein temps

Avantages offerts par ce poste

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Volunteer Time Off (VTO)

Résumé du poste

L.A. Care Health Plan is seeking a Quality Configuration Assurance Analyst III to lead complex testing, validation, and QA of the Core System (QNXT) and related applications.

You will act as SME, mentor staff, and drive process improvements to ensure accurate configurations and timely delivery. The role requires 5+ years in systems configuration within health services, with strong SDLC knowledge and the ability to meet tight deadlines.

Qualifications

• Bachelor's Degree in Business or Related Field (required)
• In lieu of degree, equivalent education and/or experience may be considered
• Master's Degree in Business or Related Field (preferred)
• At least 5 years of experience in Systems Configuration, Claims, and Health Services/Population Health
• Advanced knowledge of health plan quality assurance (claims, health services/population health, appeals, grievances)
• Knowledge of SDLC and change management methodologies, standards and best practices
• Strong analytical, organizational, and time management skills
• Able to meet strict deadlines with high accuracy
• Able to prioritize multiple tasks

Responsabilités

• Identify, develop, and recommend new/enhanced testing specifications and documentation
• Serve as SME for QA of core and surround systems configuration
• Perform complex quality audits of systems configuration
• Conduct root-cause analyses to propose improvements
• Collaborate with peers to support QA best practices and process improvements
• Provide mentorship and training to junior staff as needed
• Perform other duties as assigned

Connaissances

SDLC

Quality Assurance

Analytics

Time management

Prioritization

Formation

Bachelor's Degree in Business or Related Field

Master's Degree in Business or Related Field

Description du poste

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.

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.

Experience 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.

Physical Requirements

Light

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)