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Nexlogica · 2 months ago

Application Coordinator

California, United States

Full-time

Onsite

Entry Level

1+ years exp

Nexlogica is seeking an Application Coordinator to provide direct Epic application support and manage the software development lifecycle. The role involves analyzing user and system needs to determine optimal solutions for the organization’s business requirements.

Cloud ComputingConsultingSoftwareWeb Design

Responsibilities

Candidate will provide direct Epic application support and Epic software development lifecycle for the design, development, monitoring, testing, updating, integration, and maintenance of system stabilization

Candidate will analyze user, system, and application needs and will evaluate approaches to determine the best solution to meet VHP’s business needs via performance of the defined itemization of responsibilities above and below

Qualification

Epic implementation experienceBusiness analysisProject managementHealthcare regulatory standardsCase management workflowsHealth plan conceptsAP Claims operationsCare plans coordinationManaged care contractingHealth Planet AnalyticsEpic Care Link

Required

Experience in business analysis and project management

Knowledge of healthcare and health insurance regulatory standards

Epic implementation experience specifically at a health plan

Understanding relationships of providers and their processes in the healthcare continuum (primary care, specialists, lab ordering, surgery)

Familiarity with case management workflows and wellness programs

Familiarity with or background in quality reporting initiatives such as PQRS, ACOs/MSSP, and MU

Familiarity with health plan concepts and workflows

Understanding of operations within the AP Claims department, including claim intake, review, and payment

Familiarity with integration points with other areas of business, such as eligibility, authorizations, and internal claims

Familiarity with the benefit structures of plans

Familiarity with the use of care plans to coordinate care for members/patients

Familiarity with managed care contracting

Understanding of treatment authorization polices/processes that affect approvals or denials and the concepts of treatment referrals and the processes followed

A minimum of 1 year of application support/build/configuration and/or related business/operational experience in a health plan or health care setting

This classification requires the possession of a bachelor's degree in an IT-related or Engineering field