Texas Children's Hospital

Support and manage system optimization projects, analyze business practices and workflows, document processes, perform vendor analysis, and coordinate system training. | 7 years healthcare operations or IT experience, high school diploma or GED, with bachelor's or master's degree substituting for some experience. | Job Description We are searching for a Business Systems Analyst II -- someone who works well in a fast-paced setting. In this position, you will support and manage all phases of a system optimization or upgrade project and provides production services such as recommending improvements to strategy, system usage, or process through the application of business and technology skill sets. Reviews and analyzes programming systems including testing and documenting Epic applications. Consults with customers to identify current operating procedures and clarify program objectives. Additional responsibilities include workflow administration, data management, and performing minor modifications to the application. Think you've got what it takes Job Duties & Responsibilities • Collaborates with internal core stakeholders to identify system issues and process needs, • ensures EMR and other systems are being optimized. • Identifies system or application needs. • Conducts analysis of current business practices, user needs and workflow processes. • Documents the current as is & to be business processes. • Performs vendor analysis and makes recommendations. • Investigates alternative solutions including feasibility studies using results from vendor analysis/evaluations. • Uses data to identify trends, patterns, and opportunities for business/clinical operations. • Engages users in analysis and evaluation of functional models and prototypes; identify dependencies. • Supports business/clinical operations and serves as liaison to I.S. supporting continued system maintenance and optimization. • Works with I.S. and customers to perform functional configuration analysis for system implementations, ongoing maintenance, and other projects. • Analyze system problems and modifications. • Coordinates training of systems. Skills & Requirements • H.S. Diploma or GED • 7 years' experience in healthcare operations and/or information systems implementation, • Bachelor's degree will substitute four (4) years of work experience and a master's degree will substitute for two (2) years of work experience About Us Founded in 1996, Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Manage and direct a business operations team to ensure regulatory adherence, quality control, and performance metrics in reimbursement systems within a healthcare setting. | Bachelor's degree or equivalent experience, 5 years project management, 3 years management, and 3 years healthcare or MCO environment experience, with preferred medical coding certification. | Job Description We’re hunting for a Manager of Reimbursement Systems Configuration (telecommuter/remote), someone who’s ready to be part of the best ranked children’s hospital in Texas, and among the best in the nation. In this position, you will be responsible the for the day-to-day Operations of a Production driven team(s), maintaining State and Regulatory requirements along with departmental SLAs. Establishes, implements, and monitors quality control measures. Develops, tracks and reports performance, productivity metrics, proactively identifying trends and refocusing the direction of the team(s). Independently accesses workflows and processes for potential improvements and efficiencies. Works collaboratively with leadership and others from various areas across the health plan to evaluate and work cross functionally to implement new ideas and new strategies. Think you’ve got what it takes? Job Duties & Responsibilities Manages Business Operations Team Manage the work and the direction of the team Direct the Department standards to meet and then exceed any State Requirements Manages cross function work groups to create and implement best practices across multiple Departments Report out to Leadership and Executive Leadership with quantifiable metrics on the quality of the data Define the Department scope and review and sign off on policies and procedures Educate other departments on provider data use in all systems Establishes, implements, and monitors quality control measures related to process and/or system changes impacting reimbursement & benefits Applies regulatory and systems knowledge to ensure regulatory adherence for provider reimbursement Applies reimbursement, regulatory, payment integrity, and systems functional knowledge to ensure regulatory adherence for provider reimbursement Quality Management Coaching and developing Skills & Requirements Bachelor's Degree required Other Medical Coding Certificate Preferred 5 years Project management experience required 3 Years Management/Leadership Experience Required 3 years Healthcare industry or MCO environment required Four (4) years configuration, payment integrity, reimbursement experience can substitute a bachelor's degree About Us Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.