System analyst USC, GC Rate 45 max

Hy

I hope you are doing well.

 

I am hiring a consultant for one of my client's requirements. The Job Description for the same is written below. If you find yourself comfortable with the requirement please reply back with your updated resume

 

 

 Position:  System analyst

 

Location: Remote

 

Duration: 12 Months

VISA; USC GC  

Management at CureIS would like us to provide them with 1 more Systems Analyst – who has experience with  IDX MCA / FRM.

Look for candidates with aIDX (which is Athena IDX = an enterprise-wide RCM solution that guides health systems, hospitals, etc.) OR GE Centricity experience.  It was called Centricity or GE

Centricity in the past, but is now called Athena IDX. 

Most importantly, candidates need to have:

3-5 years minimum experience with MCA / FRM.  MCA = Managed Care App.  FRM = Financial Risk Manager

if someone does have MCA AND FRM experience, then they will be very interested in that candidate

If a candidate is more technical, then that person will probably have experience with something called AES (which is:  App Enhancement System)

we would like to consider that candidate & see that experience in the person's resume.

Candidates should have hands-on experience working with the tool, not necessarily implementing it.  Sounds like implementations are quick and all the enhancements occur after the implementation.  28 health systems in the US have it installed and some have gone to Tapestry.   

Job description:

Experience in IDX applications (SCHED, Front Desk, MCA/Open Referrals, EDI Eligibility, DBMS; integration points with other IDX applications) or other similar healthcare software applications

experience preferred.  IDX MCA/FRM experience is highly preferred.

Experience in information systems in a healthcare organization preferred

Strong administrative, analytical, problem-solving skills, written and verbal communication, and presentation skills.

In-depth knowledge of 5010 HIPAA transaction sets including 837,834,276/277

The System Analyst will be responsible for maintaining and updating the GE/Centricity/IDX Managed Care Application (MCA) module for a managed care line of business: building fee schedules, provider and vendor dictionary entries, and plan benefits and exclusions. Assists with health plan utilization management reporting for the organization. Responsible for ensuring that optimal payment methodology is in place for payments from Banner to vendors and other providers. 

Produce all health plan and monthly managed care reports. Review contracts and sets up reporting strategies and schedules. Build systems to ensure complete data transfer. Audit monthly results of transfers and repairs deficiencies.

Facilitate and implement contracts for provider and facility reimbursement including: case rates, global rates, percentage discounts, usual and customary fee schedules, RVUs, per diems, and health plan schedules and networks

Develop and conduct reviews to ensure that rate payments meet all contractual obligations and are most advantageous for the organization. Monitor Medicare and TRICARE payment methodologies and makes recommendations for contract modification

Work with the Insurance Division and Provider Relations Representatives to research contract and vendor payment issues

Maintain benefit structures and exclusions. Set up auto-adjudication processes in aIDX (GE/Centricity).

 Kind Regards

Gaurav Pandey | Absolute IT | Technical Resource Specialist

116 • Village Blvd • Suite 200 • Princeton • New Jersey • 08540

gaurav@absoluting.com www.absoluting.com