- Full Time/Contract
- Rancho Cucamonga, CA
Our Client is a not-for-profit, rapidly growing Medi-Cal and Medicare health plan serving over 1,138,447 residents of the Riverside and San Bernardino counties. Our client maintains a Positive Team Culture as demonstrated by being voted by Los Angeles News Group readers as "Favorite Overall Company to Work For, "Favorite Training Program and "Favorite Workplace Culture in their 2014 Winning Workplaces survey.
TECHNICAL ANALYST III FINANCIAL ANALYSIS
Under the direction of the Financial Analysis Manager, the Technical Analyst III is responsible for all areas of operations for capitation processing, revenue reconciliation, research and analysis. The Technical Analyst III performs highly complex technical and analytical work and must be able to understand relational database concepts, table design and structure, data normalization and apply that knowledge to company business rules. The Technical Analyst III must have a strong knowledge of Microsoft SQL Server DDL and DML.
- Run the monthly Medi-Cal Capitation programs using Microsoft SQL Server, SSIS and MS Access, audit the data, research and correct discrepancies, produce reports and review payments and reports for mailing.
- Use advanced SQL programming and Access skills to develop and implement system improvements to ensure processing efficiency and continuous improvement of current processes.
- Exercise timely and accurate data mining techniques and develop new or modify existing methodologies to perform comprehensive data analysis.
- Collaborate with IT to set up, analyze and test new systems/programs/product lines.
- Work closely with Enrollment & Eligibility, IT, Claims Configuration, Provider Contracting and Provider Services to resolve system and eligibility issues.
- Reconcile the monthly DHCS and CMS eligibility with the revenue payments.
- Provide analytical support to all company Departments.
- Perform other duties as required to insure the Health Plan operations are successful.
- Ensure the privacy and security of PHI (Protected Health Information) as outlined in company policies and procedures relating to HIPAA compliance.
- Promote teamwork and maintain effective working relationships with others throughout the organization.
SKILLS & QUALIFICATIONS
- Bachelors’ degree in Finance, Mathematics, Computer Science or related field required.
- Four (4) years’ experience programming with Structured Query Language (SQL), database development, including analysis and design, using Microsoft Access or similar PC based relational database application.
- Experience in Managed Care is preferred.
- Strong problem solving capability and analytical skills.
COMPENSATION | POSITION CLASSIFICATION
- Commensurate with Experience
- Benefited | Full-Time | Exempt