Manager IS System Configuration (Claims)

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.

JOB SUMMARY

This position is responsible for managing and configuring specified applications/systems such as QNXT and NetworX within Community Health Choice (CHC). The person in this role is expected to maintain performance within the designated applications, manage and develop staff, continuously improve the quality of processes, and work with Leadership to implement new ideas defined for Health Plan needs. Lead the configuration/solutions development team in the design, development, deployment and sustainment of business process solutions, software systems/applications. Support all departments and constant monitoring of state regulations to comply with the changes.

MINIMUM QUALIFICATIONS

Education/Specialized Training/Licensure:

Bachelor's degree in computer science, Business or related area. Four (4) years of related work experience may be substituted in lieu of degree. Work Experience (Years and Area): 3 years in configuration or application support experience. Healthcare experience preferred. Experience in the payor side of the business is highly preferred. QNXT experience is required. Texas Medicaid knowledge is highly preferred. Management Experience (Years and Area): 1 year of Informal leadership, team lead or project lead experience.

Equipment Operated:

PC literacy

SPECIAL REQUIREMENTS

Communication Skills:

Above Average Verbal (Heavy Public Contact) Writing /Composing, Correspondence /

Reports Other Skills:

Analytical Experience with

QNXT CRT

Design Medical Terms P.C.

MS Word MS Excel Work Schedule:

Hybrid Other Requirements:

RESPONSIBLE TO

Director