To protect the health and well-being of our members, employees and community, CareOregon requires all employees to be fully vaccinated against COVID-19 or have an approved medical or religious exception as a qualification of employment.

Candidates who receive an offer of employment by CareOregon, must provide proof of COVID-19 vaccination or submit a medical or religious exception request, which will be evaluated in accordance with CareOregon’s standard accommodation process.

Job Summary

This position is responsible for the execution and monitoring of critical information system jobs and processes. Performs complex procedures in the preparation of electronic data input files for processing and distributes the output. Other responsibilities include monitoring processes for accurate and timely completion and working with technical Production Support staff to identify and troubleshoot issues. This position has work that is required to be performed outside of production hours and on holidays.

Essential Responsibilities

• Execute operations to prepare data input files, execute jobs and distribute output.
• Monitor jobs to verify they are functioning properly throughout production runs, oversee those operations complete without error in a timely manner.
• Assist in the development of job sequencing and schedules.
• Maintain a calendar detailing job sequence to ensure that all tasks can be completed on time.
• Report any problems or malfunctions to the technical staff and assist in their resolution.
• Participate in the testing and implementation of system applications.
• Maintain and manage processing control logs.
• Create and maintain detailed documentation of all job processes and reference material.
• Configure provider records for electronic remittance advices and electronic fund transfer in QNXT and COWA.
• Provide technical support on system applications to internal customers.
• Provide technical support, complete requests, and maintain user access for OneCO document system.
• Assist providers and their business partners in the fulfillment of electronic remittance advice processing.
• Research, coordinate, and complete special projects as required.

Organizational Responsibilities

• Perform work in alignment with the organization’s mission, vision and values.
• Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
• Strive to meet annual business goals in support of the organization’s strategic goals.
• Adhere to the organization’s policies, procedures and other relevant compliance needs.
• Perform other duties as needed.

Experience and/or Education

Required

• Minimum 3 years’ experience in roles using computer skills to support an organization’s administration or operations functions

Preferred

• Experience in the health insurance field
• Experience with system application support
• Experience with claims systems

Knowledge, Skills and Abilities Required

Knowledge

• Knowledge of computer programming concepts and practices
• Knowledge of basic principles and practices of managed care systems, procedures, and plan products/systems
• Understand and adhere to established technical processes with a high degree of accuracy

Skills and Abilities

• Ability to learn on the job (or current skill) to use multiple system applications including:
  • Microsoft SQL Server Management Studio
  • HIPAAsuite Claim Master
  • sFTP sites
  • Microsoft BizTalk
  • QNXT core healthcare administration system
  • TriZetto Elements Enrollment Administration Manager (EAM) and Financial Reconciliation Manager (FRM)

• Proficient with Microsoft Outlook, Word, Excel
• Ability to learn the organization’s system applications including:
  • Microsoft Office 365 suite
  • SharePoint OneCO
  • Remote Desktop Connection
  • CareOregon Web Applications (COWA)
  • ServiceNow
• Effectively manage and simultaneously perform multiple tasks within specified time periods
• Proactively identify ways to improve quality, productivity, and customer service
• Proficient communication skills, including listening, verbal, written, and customer service
• Ability to document and articulate policies and instructions
• Proficient ability to network and utilize internal and external resources
• Convey appropriate level of detail effectively to all levels of the organization including non-technical staff
• Ability to explain complex information to people with little or no application knowledge
• Proactively and appropriately communicates status and needs
• Flexibility to work varied shifts and holidays
• Assist in recommending policies, documenting risks, and proposing solutions to information services staff and management
• Possess a high degree of initiative and motivation
• Produce quality and timely results, with proficient organizational skills
• Ability to creatively solve problems
• Ability to propose solutions and communicate business value
• Ability to see beyond the original request so that all logically related work is completed without needing a specific request for implied steps
• Strong time management skills to be able to work on multiple projects concurrently

• Ability to work effectively with diverse individuals and groups

• Ability to learn, focus, understand, and evaluate information and determine appropriate actions
• Ability to accept direction and feedback, as well as tolerate and manage stress
• Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
• Ability to hear and speak clearly for at least 1-3 hours/day

Working Conditions

Work Environment(s): Indoor/Office Community Facilities/Security Outdoor Exposure

Member/Patient Facing: No Telephonic In Person

Hazards: May include, but not limited, to physical and ergonomic hazards.

Equipment: General office equipment and/or mobile technology

Travel: This position may include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.

Schedule: Monday – Friday Varied Shifts and Holidays

Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment

Veterans are strongly encouraged to apply.

Equal opportunity employer. This company considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.