• Director, Business Systems Configuration

    Job ID
    2019-91243
    Employment Type
    Full Time
    Department
    Business System Configuration Support
    Hours / Pay Period
    80
    Facility
    Dignity Health Management Services Organization
    Shift
    Day
    Location
    Bakersfield
    State/Province
    CA
    Standard Hours
    Monday - Friday (8:00 AM - 5:00 PM)
    Work Schedule
    8 Hour
  • Overview

    Overview

    The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

    What We Offer

     

    Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

     

    • This position will report to the: VP, Operations
    • Percentage Travel Required/Frequency: 10%
    • FLSA Status: Exempt
    • Remote Worker: No

    Responsibilities

     

    Complies and analyzes departmental production data, shifting priorities as necessary. Project manages all Configuration implementations and process changes. Responsible for the performance of employees and making sure employees complete their duties in a timely and accurate manner. Encourage and motivate employees in a positive way. Communicates well with other employees, provides training and support the Configuration Technicians.  Prepares schedules and written performance reviews. Prepares and delivers disciplinary action against an employee when there is a problem. Make recommendations or decisions about promotions or raises.

     

    Provides leadership, direction and oversight to the configuration staff.  Ensures quality and accuracy standards are maintained.  Compiles, reviews and analyzes department production data, shifting priorities as necessary.  Project manages configuration implementations and process changes.  Responsible for maintaining acceptable departmental effectiveness, ensuring that all configuration processes are completed to standards. 

    Qualifications

    EDUCATION & EXPERIENCE

     

    • Bachelors degree in business administration or management information systems or related field
    • A combination of 5 years experience adjudicating healthcare claims, working in configuration using QNXT system, or working as a Business or Systems Analyst in the healthcare industry
    • Experience working with database management systems, with experience in system migrations preferred
    • Previous experience supervising the work of others
    • Relevant work experience may be substituted for educational requirements

     

    JOB KNOWLEDGE, SKILLS & ABILITIES

     

    • Working knowledge of configuring systems for various business areas such as eligibility, enrollment, provider contracts, plan benefits, and claims (capitation)?
    • Knowledge of database management and reporting methodologies
    • Knowledge of ICD-9, CPT-4, and HCPCS coding
    • Ability to read, analyze and accurately interpret moderately complex contract and benefit language
    • Advanced knowledge of MS Windows applications, including Access, Excel and Word. Knowledge of Crystal Reports
    • Project management skills and knowledge of project lifecycles
    • Proven interpersonal skills, and written/verbal communication skills to effectively interact with system users with varying levels of expertise, effectively supervise the work of others, and work in team environment
    • Knowledge of managed care benefit administration
    • Proven analytical and problem solving skills
    • Ability to learn new skills and technologies quickly
    • Ability to engage in lateral thinking both individually and in teams, to meet the needs of the project
    • High level of detail orientation
    • Manages the configuration of projects, development and certification and accreditation lifecycles for customer's application.
    • Reviews program documentation, maintains schedules, performs assessments, develops/improves and implements configuration management processes/procedures.
    • Reviews technical and planning documents to ensure accuracy and to ensure impacts are identified, understood, and communicated.
    • Performs testing on new configurations for reliability and accuracy, and identifies and corrects problems. 
    • Documents processes and serves as a resource for others. 
    • Ability and desire to work in a fast-paced environment with strict deadlines and tight timelines
    • Strong organizational skills with ability to prioritize multiple priorities and work independently
    • Reviews, interprets and applies contract and benefit information to application software.
    • Evaluates and resolves application software user issues.
    • Provides instruction to end users in the use of the application software, answers questions and assists in resolving problems regarding the methods and procedures for using application software.
    • Identifies and obtains appropriate resources for the resolution of complex problems by making minor changes (repairs) to application software and/or enters specialized commands or data into application software to achieve desired results.
    • Evaluates new and revised lines of business, identifies possible improvements in application software and makes recommendations to management.
    • Conducts testing of new configurations and fault finding.
    • Communicates on technical issues with individuals with varying degrees of computer familiarity.       
    • Audits the work of assigned configuration staff.   
    • Leads the work of assigned staff, providing direction, support and training as needed. 
    • Keeps Manager advised of performance issues and works with Manager to develop employees’ skills, knowledge and abilities.
    • Analyze configuration processes and determine best practices. 

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