Business Analyst, Sr. (Contract Configuration)

Business Analyst, Sr. (Contract Configuration)

CalOptima

CalOptima Health is seeking a highly motivated an experienced Business Analyst, Sr. (Contract Configuration) to join our team. The Business Analyst Sr (Contract Configuration) will oversee, maintain and manage system enhancement on behalf of the Contracting department's contract management system. The incumbent will be responsible for program provider contracts with system designed mail merge fields, alternant terms options and custom exhibits that support the provider type. The incumbent will build custom forms which populate contract reimbursements, payment terms, provider type(s), sub-specialties, services and metadata. The incumbent will maintain updates to pre-approved templates and the language library and oversee the end-to-end contract life cycle system management processes. The incumbent will administer regular and ad-hoc reporting, oversee the deployment of bulk contracts, support the return of outstanding contracts and perform user acceptance testing after system updates. The incumbent will provide training to end users and assist Information Technology Services (ITS) with system enhancements and support requests from leadership and the board of directors and as required by the Department of Health Care Services (DHCS).

Position Information:

• Department: Contracting
• Salary Grade: 311 - $77,863 - $124,581 ($37.43 - $59.8947)
• Work Arrangement: Partial Telework
  
  **This position is eligible for telework in California.**

Duties & Responsibilities:

• 70%% - Contract Management System (CMS)
  • Oversees, manages and maintains the department's contracts database, codes and programs documents, administers bulk distribution of contracts and amendments and maintains template updates and history.
  • Manages contract templates and incorporates appropriate styles, autonumbering, font/font size, pagination and standard headers and footers.
  • Reviews new templates for consistency, language alignment and configuration.
  • Develops custom forms that populate contracts, payment terms, provider types, cover letters, routing forms and metadata.
  • Develops supporting documents (exhibits) to complement contract templates.
  • Loads, tests and audits setup of contracts, amendments and supporting data fields, exhibits and forms in the contracts database.
  • Provides feedback on system limitations or expansion needs as a user of the contract database.
  • Participates in testing and validation of system changes and improvements.
  • Develops contract activity trend reports processed through CMS monthly, quarterly and annually.
  • Performs regular audit of contract builds and provides training to end users.
  • Develops back-end quality control reports to monitor data entry requirements and integrity.
  • Oversees end-to-end system management, validates system upgrades and ensures business needs are met.
    
    
• 25%% - Department Support
  • Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  • Serves as subject matter expert to ITS and other departments for overall database configuration and reporting.
  • Develops and maintains the department's required regulatory reports, metrics and completion factors (returned contracts/amendments).
  • Provides cross training and mentors support staff on system development and template management.
  • Serves on committees, work groups and other process improvement teams to assist in improving contract configuration.
  • Recognizes and alerts management of trends that fall outside of contract parameters.
    
    
• 5% - Completes other projects and duties as assigned.

Minimum Qualifications:

• Bachelor's degree in health care administration, business administration, computer science or a related field PLUS 3 years of experience managing complex provider contract negotiations, including fee for service and capitated reimbursements, developed base agreements and custom terms/provisions required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
  
• Experience working within a contract management system required.
  
• Experience in a managed care environment required.
  
• Proficient in Excel and Word with successful completion of skills assessments required.

Preferred Qualifications:

• 1 year of experience as a business data analyst in the health care industry.

Required Licensure / Certifications:

• n/a

Knowledge & Abilities:

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Work Environment:

If located at the 500, 505 Building or a remote work location:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.

If located at PACE:

• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

If located in the Community:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.

About CalOptima Health:
CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About our Benefits & Wellness options:
At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, work schedules that allow every other Monday or Friday off (9/80 schedule), and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the 2024 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.

IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is October 15, 2024 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.

Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.


To apply, please visit: https://jobs.caloptima.org/jobs/business-analyst-sr-contract-configuration-505-city-parkway-west-california-united-states







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