L.A. Care Health Plan · 1 day ago
Core Systems Configuration Analyst III
Los Angeles, CA
Full-time
Onsite
Senior Level
$92K/yr - $151K/yr
5+ years expL.A. Care Health Plan is the nation’s largest publicly operated health plan, created to provide health coverage to low-income Los Angeles County residents. The Core Systems Configuration Analyst III is responsible for complex technical and analytical work related to the maintenance and update of the configuration of the organization's Core Systems applications and databases, while also serving as a subject matter expert for configuration improvements and collaboration across departments.
FitnessGovernmentHealth Care
Responsibilities
Manage complex benefit dictionaries, evidence of coverage tables, provider contractual obligations (including capitation and fee-for-service contracts), Division of Financial Responsibility (DoFR), etc. and related documentation
Serve as a subject matter expert for configuration change management testing and related best practices
Facilitate production controls and system configuration data codification
Monitor and review systems edits, response time issues, etc. and conducting related advanced root cause analysis to identify issues and provide well thought-out recommendations for resolution
Identify and facilitate the implementation/enhancement of systems, process improvements, and best practices
Interface and collaborate with peers within and outside of the department and the organization to support configuration management best practices, systems enhancement processes, management of the system configuration life cycle management project/program plans, tracking of configuration change operational issues and resolution
Perform peer review for all levels of staff and apply advanced skillset to ensure quality of the work product
Perform other duties as assigned
Qualification
Required
Bachelor's Degree in Business Administration or Healthcare Administration
At least 5 years of experience in a Systems Configuration, Claims or other Operations department in a healthcare organization
Advanced knowledge of and experience with interpreting and analyzing complex pricing mechanism and contractual terms with providers, delegated groups and related contractual scenarios
Knowledge of and experience with utilizing SDLC and related change management methodologies, standards, and best practices
Advanced knowledge of and experience with current Commercial, Medicare, and Medicaid rules and regulations and core systems code and data sets, etc
Advanced understanding of managed care operations (including but not limited to, claims processing; provider contracting, network and data management; complex pricing mechanisms; etc.) and the systems that support these operations
Knowledge of Systems Development Life Cycle (SDLC) procedures in planning the systems configuration
Advanced understanding of the application of the Division of Financial Responsibility (DoFR) to claims processing
Strong communication, analytical, organizational, and time management skills
Able to manage projects and initiatives end-to-end
Able to meet strict, tight deadlines with a high level of accuracy
Able to prioritize multiple tasks
Able to work collaboratively with various level of peers and management throughout the organization
Preferred
Master's Degree in Business Administration or Healthcare Administration
At least 5 years of experience working with a California Medi-Cal managed care plan or commercial health plan, medical group, or management services organization
Benefits
Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)
Company
L.A. Care Health Plan
L.A. Care’s mission is to provide access to quality health care for L.A.
1001-5000 employees
H1B Sponsorship
L.A. Care Health Plan has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2024 (1)
2023 (1)
2021 (3)
2020 (1)
Funding
Current Stage
Late StageLeadership Team
Melanie Rainer
Chief Strategy and Transformation Officer
Recent News
MarketScreener
2025-08-27
2025-08-04
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