Analyst, Claims Data Quality Assurance
FRENCH CAMP, CAPosted 30+ days ago
Job summary
Job post source
This job is directly from Health Plan of San Joaquin/Mountain Valley Health Plan
Job overview
The Analyst, Claims Data Quality Assurance role focuses on ensuring high-quality claims data through oversight, audits, and collaboration to improve data accuracy and efficiency within the health plan.
Responsibilities and impact
The analyst will provide claims data QA oversight, develop data quality metrics and models, conduct audits, collaborate with developers and analysts to improve systems, and recommend new testing tools and strategies.
Compensation and benefits
The position offers a competitive salary, robust health/dental/vision insurance, generous paid time off, CalPERS retirement pension with employer contributions, flexible spending accounts, employer-paid life and disability insurance, education reimbursement, and other employee perks.
Experience and skills
Candidates should have a bachelor's degree in computer science or related field, at least three years of QA experience or equivalent, strong knowledge of analytics, claims data, SQL, programming languages, quality assurance and audit processes, and good communication and leadership skills. Experience in Medi-Cal or Managed Care and certifications like Quality Assurance Certification and Certified Scrum Master are preferred.
Career development
The role offers education and training reimbursement along with employer-paid elective learning courses, providing opportunities for professional growth and skill enhancement.
Work environment and culture
The company values diversity and inclusion, promotes a mission-driven environment focused on community and members, and supports a collaborative and respectful workplace.
Company information
Health Plan of San Joaquin/Mountain Valley Health Plan is a mission-driven health organization focused on serving its community with comprehensive health plans and services.
Job location and travel
This is a remote-eligible position requiring candidates to reside in California.
Unique job features
The job offers remote work eligibility, a chance to work on diverse projects with people at all organizational levels, and involvement in mission-driven community service.
Company overview
Health Plan of San Joaquin (HPSJ) is a not-for-profit managed care organization that provides healthcare services to Medi-Cal beneficiaries in California's San Joaquin and Stanislaus counties. Founded in 1996, HPSJ aims to improve community health by offering comprehensive healthcare plans, including medical, dental, and vision coverage. The organization generates revenue through state and federal funding allocated for Medi-Cal services. HPSJ's mission is to ensure accessible, quality healthcare for underserved populations, leveraging partnerships with local healthcare providers and community organizations to enhance service delivery and patient outcomes.
How to land this job
Position your resume to highlight expertise in claims data quality assurance, emphasizing your experience with data QA oversight and audit processes relevant to healthcare claims.
Focus on showcasing your proficiency with SQL, Python, .NET, SSIS, SSRS, and Agile methodologies, as well as your ability to develop and implement data quality metrics and models.
Apply through multiple channels including the Health Plan of San Joaquin/Mountain Valley Health Plan corporate careers page and LinkedIn to maximize your application visibility.
Connect on LinkedIn with professionals in the Claims Data or Provider Services divisions at Health Plan of San Joaquin/Mountain Valley Health Plan; start conversations by asking about recent data quality initiatives or expressing interest in their approach to claims data accuracy.
Optimize your resume for ATS by incorporating keywords from the job description such as 'claims data QA,' 'data quality metrics,' 'SQL queries,' 'audit processes,' and 'Agile development' to ensure it passes automated screenings.
Utilize Jennie Johnson's Power Apply feature to automate tailored applications, identify all relevant job posting sites, and find LinkedIn connections for networking, allowing you to focus your energy on preparing for interviews and skill development.
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