Applications Analyst - – San Bernardino

$48,620 - 68,640

Under direction of the Operations Support Manager the Application Support Specialist is responsible for the support functions related to the testing, implementation, configuration and on-going maintenance of programs. The duties will include research and analysis of application programs, coordination of user training, management, user support, product testing, problem solving and development of policies and procedures related to application usage.

RESPONSIBILITIES:
1.Coordinate the Monthly Eligibility Processing throughout the month including overview of provider and member eligibility file creation and Diamond file upload processes.
2.Develop a comprehensive understanding of member eligibility application programs, features and capabilities, including Diamond, Data Warehouse and all member eligibility relational databases.
3.Identify and analyze current member eligibility processes and requirements to ensure quality assurance and data integrity.
4.Coordinate data analysis needs assessment for application implementation and configuration, including Diamond, Data Warehouse and any member relational database.
5.Coordinate the Pay For Performance (P4P) Incentive Program by executing, auditing, testing and reporting the monthly payment process.
6.Coordinate member eligibility issues with the State and County entities and other departments.
7.Maintain the Operations Policy and Procedures including the creation of process workflow diagrams as they relate to the application program.
8.Aid in the redesign of business processes and identify new business rules that impact Diamond, Data Warehouse and any member eligibility databases.
9.Produce and manage application testing scenarios and testing schedules for all member eligibility programs and applications, including Diamond, Data Warehouse, and P4P Well Child and Immunizations.
10.Develop end-user training curriculum and train users on application usage.
11.Report the status of assigned tasks and / or related problem issues to the Operations Management.
12.Develop policies and procedures related to application configuration, general usage and maintenance.
13.Any other duties as required ensuring the Health Plan operations are successful.
14.Ensure the privacy and security to HIPAA compliance.

QUALIFICATIONS:
Education/License:Graduation from an accredited four year college with a major in computer science, mathematics, accounting, public or business administration, or health care. For non-degreed candidates, two years of applicable experience may be substituted for each year of college required.

Experience: Two years experience with managed care medical management and / or managed care management business operations. Strong knowledge of Client/Server applications using relational databases. Five years experience working in a health care environment.


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Salary: 55000 - 65000