Job DescriptionJob Description
The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. Limited Term position.
What You Will Be Doing: The Senior Accountant will support management decision making by performing or overseeing financial functions related to the collection, recording, analysis and presentation of accurate financial statements, in a manner that ensures accuracy and integrity of financial data and meets internal and external requirements. Under general supervision, responsible for preparing, reviewing, analyzing and monitoring financial data, and distributing financial reports. Hybrid position.
Our Vision:Continuously improve the health of our community. Our Mission:We provide healthcare value and advance wellness through community partnerships.
Essential FunctionsManages the month-end close and reviews balance sheet account reconciliations; makes corrections as necessary.Reviews the accounts variance analysis reports and makes recommendations as necessary.Creates, maintains and distributes internal and external financial reports, and associated support files and systems.Assists in preparing for, conducting and overseeing audits, and associated corrective action plans and other activities.Develops and maintains documentation of processes, procedures and other items.Provides training and guidance and reviews work of less senior staff.Creates and maintains routine and ad hoc reports, and other documents.Provides backup to various activities, including payroll, check runs, capitation and membership accounting. What You Bring:Knowledge, Skills, Abilities and CompetenciesProduces work that is accurate and complete.Produces the appropriate amount of work.Actively learns through experimentation when tackling new problems, using both successes and failures to learn.Rebounds from setbacks and adversity when facing difficult situations.Knows the most effective and efficient process to get things done, with a focus on continuous improvement.In-depth knowledge of accounting and auditing theory, principles and practices, and ability to apply to a wide variety of accounting transactions.Interpersonal skills -interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people.Strong oral and written communication skills, with ability to explain complex information and present financial information in meaningful formats.Ability to work independently and as part of a team.Demonstrated commitment to HPSJ’s strategy, vision, mission and values.Ability to proactively identify issues, present alternative solutions with pros and cons of each, and make recommendations for implementation of solutions to those problems.Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines.Strong knowledge of data analysis and communication/reporting tools and techniques, with ability to perform analysis and resolve problems of moderate complexity and recognize and act on trends.Strong skills in data identification, integration, validation, manipulation, interpretation and reporting.Strong skills in automated accounting systems including report writing.Basic leadership skills, including but not limited to the ability to influence without authority and motivate others.Demonstrated commitment to HPSJ’s strategy, vision, mission and values.Ability to comprehend changes in laws relating to finance, and draft policies and procedures for documenting compliance.Strong mathematics skills, including the ability to calculate ratios, perform simple algebra and statistical formulas.Advanced skills in Excel, including ability to create complex formulas, pivot tables, macros and VLookup.Strong skills in Windows, Word and Outlook.Ability to handle confidential information with appropriate discretion.Ability to speak and be understood in English.PreferredKnowledge of and skills in Great Plains.Knowledge of and skills in Management Reporter.Knowledge of QNXT as it relates to accounting.Knowledge of managed healthcare accounting. What You Have:Education and ExperienceRequiredBachelor’s Degree in Accounting; andAt least three years creating journal entries, reconciling and analyzing accounts, preparing and analyzing financial statements; andExperience as an accountant in a managed care organization; orEquivalent combination of education and experience.PreferredExperience in accounting in a health plan, managed care, Medi-Cal/Medicaid and/or MedicareLicenses, CertificationsRequiredNoneWhat You Will Get: HPSJ Perks:Competitive salaryRobust and affordable health/dental/vision (90% paid medical for employees and 100% paid dental/vision for employees) with choices in providers.Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution planTwo flexible spending accounts (FSAs)Employer-Paid Term Life and AD&D InsuranceEmployer-Paid Disability InsuranceEmployer-Paid Life Assistance ProgramHealth AdvocacySupplemental medical, legal, identity theft protectionAccess to exclusive discount mallEducation and training reimbursement in addition to employer-paid elective learning courses.A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.A shorter commute – if you’re commuting from the Central Valley to the Bay Area.Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.
We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit. HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics. Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.
Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change. Remote position. MUST reside in California. Must have Edifecs hands-on experience with Healthcare EDI! What You Will Be Doing:Under general supervision, responsible for complex data processing, creating procedures and systems, providing detailed technical analytics for complex automated process improvement procedures, and designing critical and complex core system modifications for the company. Sr. EDI Developer elicits complex business requirements through group meetings, interviews, observation, and/or existing systems documentation. This role independently contributes to the EDI team with complex and comprehensive documentation of the technical requirements in a format that facilitates business and technical communication and understanding amongst the business department or individuals. The Sr. EDI Developer must have the ability to independently analyze data, draw sound conclusions, and is able to interpret and follow detailed and precise written and oral instructions such as checklists. The Sr. EDI Developer will lead communication and facilitation efforts to present the documented findings and results from an analytical engagement. The position will require you to work with and mentor people of various professional, vocational, and educational backgrounds. Remote. Must Reside in California Our Vision:Continuously improve the health of our community. Our Mission:We provide healthcare value and advance wellness through community partnerships. Essential Functions:Works with Executives, Management, Staff, or Business representatives, to identify and document complex business concepts or processing conflicts; may work under the direction of a Project Manager or a Senior EDI Analyst. Provides formal user education with software productivity and technical tools such as SSRS, SSIS, SharePoint, Microsoft Office, Visio, Team Foundation Server, or automation tools to document business and technical process requirements related to a technology system. Comprehends, analyzes, and documents business or process requirements using personal interviews, document analysis, meetings, surveys, process documents, or actual scenarios.Analyzes and documents functional business environments that facilitate work throughout the company. Develops complex business requirements and specifications through internal and external research to complete technical analysis and articulate and formally present research to various skill levels. Facilitates business meetings leveraging the Agile process to assist business units in the “What” session to ensure the creation and documentation of stories and acceptance criteria. Provides technical interpretation to other technical teams in the Agile “How” session to understand technical requirements related to the business stories and acceptance criteria. Effectively communicates and collaborates with internal and external customers in support of analytics or problem resolution. Analyzes and evaluates information gathered from multiple sources to resolve reconciliation conflicts. Comprehends and implements system configuration changes of the managed care core system software to process data transactions for business functions such as eligibility, claims, authorizations, and case management. Designs, develops, and/or assists in the testing and implementation of software systems used by the organization. Identifies and creates personal process checklists that will be used to process HPSJ programs and applications to support departmental activities. May assume the duties of a Project Manager for medium to large-sized projects using standard PMBOK processes to identify scope, requirements, resources, and stakeholders using standard analysis techniques. Lead and mentor in areas that need cross-training and independently provide knowledge and documentation exchange to educate team members in Analytical roles in support of team redundancy. What You Bring:Knowledge, Skills, Abilities and Competencies Required In-depth knowledge of and ability to apply the American National Standards Institute (ANSI) formats that govern healthcare Electronic Data Interchange (EDI). Must have at least four (4) years of experience developing and maintaining Healthcare EDI X12N transactions, including batch and real-time formats such as: 837I/837P, 274, 834, 835, 270/271. Requires at least two (2) years of Edifecs hands-on experience with Healthcare EDI X12N transactions, including analytics, mapping, developing, testing, and deployment. Has experience with HL-7 and NCPDP File Formats, QNXT Healthcare Core Systems, including knowledge of QNXT EDI Manager and QNXT Connect (MS BizTalk). Advanced knowledge of and ability to apply SDLC (Software Development Life Cycle) and Agile Scrum Methodologies. Successfully engage in multiple complex initiatives simultaneously forms of electronic resources in everyday communications. Proficient with the structure query language (SQL) for analytical data mining, software development, TFS, and business reporting. In-depth knowledge and understanding of medical terminology to include ICD, CPT, and HCPCS coding systems related to encounters and 837s. Strong oral and written communication skills, with the ability to effectively communicate complex technical issues in terms clearly understood by technical and non-technical audiences and write technical specifications. Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people. Effectively communicate and collaborate with internal and external customers in support of analytics or problem resolution. Strong listening skills, with the ability to accurately receive and understand messages. Strong problem solving and analytical skills, with ability to determine key issues, develop effective action plans.Comprehensive understanding of the various department technological resources and their roles in order to utilize various implement successful conclusions. Produces work that is accurate and complete. Produces the appropriate amount of work. Actively learns through experimentation when tackling new problems, using both successes and failures to learn. Rebounds from setbacks and adversity when facing difficult situations. Knows the most effective and efficient process to get things done, with a focus on continuous improvement. Demonstrates a commitment to HPSJ’s strategy, vision, mission, and values. Time management and organizational skills. Uses time effectively and efficiently. Values time. Concentrates his/her efforts on the more important priorities. Can attend to a broader range of activities. Meets deadlines. Ability to work independently and as part of a team. Basic mathematics skills. Strong skills in Windows, Excel, Word, Outlook, and Visio. Ability to speak and be understood in English.
What You Have:Education and ExperienceRequired Bachelor’s degree in computer science, Mathematics, or related field; and At least six years progressive experience in an EDI role or similar analytical position for a medium to large organization with a structured IT department; or At least ten years of progressive experience in an EDI Analyst capacity or similar analytical position for a medium to large organization with a structured IT department. At least 2 years Edifecs hands-on experience with Healthcare EDI. Preferred Experience in healthcare. Experience with Tableau. Licenses, CertificationsNone required. What You Will Get: HPSJ Perks:Competitive salaryRobust and affordable health/dental/vision with choices in providersGenerous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution planTwo flexible spending accounts (FSAs)Employer-Paid Term Life and AD&D InsuranceEmployer-Paid Disability InsuranceEmployer-Paid Life Assistance ProgramHealth AdvocacySupplemental medical, legal, identity theft protectionAccess to exclusive discount mallEducation and training reimbursement in addition to employer-paid elective learning courses.A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.A shorter commute – if you’re commuting from the Central Valley to the Bay Area.Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects. We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit. HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics. Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.
Job DescriptionJob DescriptionThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
What You Will Be Doing:This position is responsible for managing major system configurations, health plan implementations and conversions within the System Configuration team. The primary responsibilities include the accurate interpretation of specific state and/or federal guidelines that impact benefits, contracts, codification, and business requirements and converting them into configuration parameters within the core systems. Other responsibilities are coding, updating and maintenance benefit plans, provider set-up (demographic and contracts affiliations), fee schedules and various system tables through the user interface.The Senior Configuration Analyst elicits complex business requirements through group meetings, interviews, observation, and/or existing systems, and business or policy documentation. This role independently mentors and contributes to the Configuration Analysts team with complex and comprehensive documentation of the technical requirements or systems modifications in a format that facilitates a business and technical communication and understanding amongst the business department or individuals. The Senior Configuration Analyst must have the ability to independently analyze or mine data, draw sound conclusions, and is able to interpret and follow detailed and precise written and oral instructions such as checklists, process diagrams, and policy. The Senior Configuration Analyst will lead communications and facilitation efforts to present the documented findings and results from an analytical engagement. The position will be required to work with and mentor people of various professional, vocational, and educational backgrounds. Our Vision:Continuously improve the health of our community. Our Mission:We provide healthcare value and advance wellness through community partnerships. Essential Functions:• Independently works with Executives, Management, Staff, or Business analysts to identify, document, and redesign complex business concepts or processing conflicts.
• Lead and mentor in technical areas and independently provide knowledge and documentation exchange to educate team members in Analytical roles in support of team redundancy.
• Master and provide formal user education with software productivity and technical tools such as Microsoft Office, Visio, Team Foundation Server, or Attachmate to document business and technical process requirements related to a technology system.
• Ability to independently create technical processing macros using programming logic and native functions to perform repetitive or analytical tasks within productivity software such as Microsoft Office and Attachmate.
• Comprehend, analyze, and document business or process requirements using personal interviews, document analysis, meetings, surveys, process documents, or actual scenarios.
• Take on duties of a Project Manager for medium to large sized projects using standard PMBOK processes to identify scope, requirements, resources, and stakeholders using standard analysis techniques.
• Analyze and document functional business environments that facilitate work throughout the company.
• Develop complex business requirement specifications through internal and external research to complete technical analysis, and articulate and formally present research to various skill levels.
• Lead business meetings leveraging the Agile process to assist business units in the “What” session to ensure the creation and documentation of stories and acceptance criteria.
• Lead Configuration and Project teams in the Agile “How” session to understand technical requirements related to the business stories and acceptance criteria.
• Effectively communicate and collaborate with internal and external customers in support of analytics or problem resolution.
• Successfully engage in multiple complex initiatives simultaneously
• Recommend reconciliation points necessary after a comprehensive process or data analytics engagement to mitigate/resolve present and future reconciliation conflicts.
• Possess excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts.
• Limited skills in capacity of the various department technological resources and their roles in order to provide detailed analytics in everyday communications.
• Master of the American National Standards Institute (ANSI) formats that govern healthcare Electronic Data Interchange (EDI).
• Expert ability in the structure query language (SQL) for analytical data mining, software development, TFS, and business reporting.
• Comprehend and implement system configuration changes of the managed care core system software to process data transactions for business functions such as eligibility, claims, authorizations, and case management.
• Mentors and leads in the creations of testing plans that are used in the testing and implementation of software systems used by the organization.
• Comprehensive understanding in medical terminology to include ICD, CPT, and HCPCS coding systems.
• Oversee, identify, and create process checklists, for self and other analysts, which will be used to process HPSJ Health Systems (HPSJ) programs and applications to support departmental activities. What You Bring:Knowledge, Skills, Abilities and CompetenciesRequired • Extensive knowledge of all core QNXT system modules
• Ability to configure and update all standard core QNXT system modules
• Extensive knowledge of core QNXT system databases
• Ability to independently perform complex system and data analytics
• Extensive knowledge of other systems such as OPTUM PPS, CES, and NetworX Pricer and Modeler
• Extensive knowledge of other systems such as JIVA or other Medical Management Platforms• Ability to independently create intermediate SQL queries
• Ability to independently leverage advanced SQL functions such as temp tables, multiple joins, inner/outer joins, and advanced analytics.
• Ability to independently create pivot tables from SQL output
• Ability to independently leverage all data sets and DBs
• Ability to independently create scripts to update data
• Extensive knowledge of core system databases and the ability to assist other technical staff with navigating system data, including the data structures for reporting.
• Ability to independently comprehend technical infrastructure including systems, DB, integration points, and reporting for coordination of efforts on systems managed by config team
• Ability to provide recommendations for process improvement, automation, and enhancements
• Ability to effectively communicate with technical and non-technical disciplines
• Ability to independently lead in cross functional business and technical meetings
• Ability to independently perform Scrum Master duties
• Ability to maintain effective working relationships with all teams
• Ability to independently perform Scrum Master duties
• Ability to lead small (3-6 months) department projects
• Extensive experience and knowledge of the Agile Methodology
What You Have:Education and ExperienceEducation:Bachelor’s degree in Computer Science, Mathematics from an accredited institution or related field and six (6) years progressive experience in a Configuration Analyst capacity or similar Analytical position for a medium to large organization with a structured IT department in healthcare. ORExperience:Healthcare experience: 10+ years.Claims Operations or application vendor experience: 5 + years.Benefit and Contract Configuration experience: 3+ yearsExperience interpreting benefits, contracts and other business requirements: 5+ yearsExperience in medical coding initiatives and coding guidelines: 3 + years Experience in Medical Management system configuration. 3+ years Experience in Medical Management system configuration. 3+ years Expert level of knowledge in QNXT and/or JIVAThe incumbent must have basic technical skills that come from a Degree in Information Systems or 6-8 years of general analytical experience.
License: None required
What You Will Get: HPSJ Perks:Competitive salaryRobust and affordable health/dental/vision with choices in providersGenerous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution planTwo flexible spending accounts (FSAs)Employer-Paid Term Life and AD&D InsuranceEmployer-Paid Disability InsuranceEmployer-Paid Life Assistance ProgramHealth AdvocacySupplemental medical, legal, identity theft protectionAccess to exclusive discount mallEducation and training reimbursement in addition to employer-paid elective learning courses.A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.A shorter commute – if you’re commuting from the Central Valley to the Bay Area.Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects. We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit. HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics. Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.
