Job Description
Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
• Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
• Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
• Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
• Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
Skills / Requirements
JOB SUMMARY:
Responsible for understanding the business and business requirements in relation to applications / systems, reporting, and processes. Research system / application issues, recommends solutions, and coordinate system / application modifications to correct issue. Works with business units to clarify new requests and interpret needs. Provides functional system /application knowledge, as well as technical expertise for specified system / applications. The job includes significant or complex system configuration, process design, data analysis and issue resolution. Assist with the development of standards and best practices, design of user guides / procedures.
MINIMUM QUALIFICATIONS:
1. Education/Specialized Training/Licensure:
- Bachelor's Degree in Business, Information Technology, Computer Information Systems, Systems Engineering, related fields or four (4) years of related work experience may substitute for the bachelor's degree.
2. Work Experience (Years and Area):
- 2 years of experience in information systems.
- Salesforce experience strongly preferred.
SPECIAL REQUIREMENTS:
1. Communication Skills:
Above Average Verbal (Heavy Public Contact)
Writing /Composing (Correspondence / Reports )
2. Other Skills:
Analytical
Mathematics
Medical Terms
Statistical
P.C.
MS Word
MS Excel
3. Advanced Education:
Bachelor's Degree Major: Bachelor's Degree in Business, Information Technology, Computer Information Systems, Systems Engineering, related fields or four (4) years of related work experience may substitute for the bachelor's degree.
4. Work Schedule: Flexible
5. Other Requirements: Knowledge:
* Knowledge of Microsoft technologies, troubleshooting application issues and errors
* Strong SQL Server experience.
* Strong knowledge of technical and business analysis
* Knowledge of relational databases, web and client-server concepts
* Knowledge of the healthcare industry in general and specifically of the health insurance environment is preferred.
* Knowledge of ETL Tools and Techniques
* Understanding analyzing, documenting, and providing resolution for assigned complex issues.
Preferred Knowledge:
* Knowledge of the healthcare industry in general and specifically of the health insurance environment is preferred.
Skills:
* Strong business analysis and analytical, problem-solving, organization, and customer service skills. Strong communication and presentation skills (both oral and written).
* Ability to work independently and be effective in ambiguous and/or changing situations.
* Identify and diagnose unknown/unmet, complex issues.
* Creatively formulate solution options for complicated problems
* Understand design principles across multiple problems / solutions
* Perform Report development
* Write complex T-SQL queries
* Ability to work with the following Microsoft technologies:
* Microsoft SQL Integration Services, SQL Server Analysis Services and SQL Server Reporting Services, and Internet Information Services
* Microsoft SQL Server 2008+
* Microsoft Office suite, with strengths in Excel, Word, and Visio
* Microsoft Team Foundation Server
* Ability to work with IS resources, server administrators, database administrators, solution architects and developers
Preferred Skills:
* Ability to work with the Microsoft SharePoint is preferred.
