Operations Systems Analyst II

 
Position: Operations Systems Analyst II

Job ID: 161082

Department: CONFIGURATION TEAM

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.To join our community of 14,000+dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for an Operations Systems Analyst -- someone who works well in a fast-paced setting. In this position, you will be responsible for the activities related to system updates, new health plan implementations and conversions within the Business Operations teams. This role provides oversight to configuration of contracts, configuration of benefits, configuration of claim edits, update to fee schedule and contract rates, and medical code updates.

 

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Responsibilities :

  • Supports Claims staff with complex claims and payment issues related to system configuration - benefits, contracts and fee schedules
  • Researches and resolves claims issues and pended claims timely and accurately. This may include identifying configuration issues and updating systems, or reaching out to other parties to resolve configuration questions
  • Assists in planning and coordination of application upgrades and releases, including development and execution of test plans for the Business Operations Department
  • Performs configuration analysis for system design associated with small and less complex projects
  • Recommends modifications to application design or current procedures to maximize advantages of existing resources
  • Coordinates implementation and upgrades of systems.
  • Participates in or leads training sessions with users to review new configurations, new systems, or system updates
  • Assists with determining if current training materials/documentation is adequate and assists with updating or developing materials/documentation for training as needed


Qualifications:

  • Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s, unless approved for a medical or religious exemption
  • High school diploma or GED required
  • Bachelor’s degree in computer science, business administration, healthcare administration or related field preferred
  • 4 years health plan payor information systems experience required
  • A Bachelor’s degree may substitute for the two years of required work experience


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