Sr. IT Manager of Enterprise Applications - Claims System

Company: Partnership HealthPlan of California
Location: Fairfield
Posted on: January 16, 2025

Job Description:

OverviewThe Sr. IT Manager of Enterprise Applications - Claims System will oversee and manage HRP Transaction Management functions effectively. This entails leading a team, prioritizing tasks, establishing and enforcing standards, training staff, testing and implementing new code, analyzing user requirements, and aligning work with business priorities.Responsibilities

• Lead Health Rules Payer (Claims System) Transaction Management responsibilities.
• Maintain comprehensive knowledge of HRP, HRP Configuration, and its integrations.
• Maintain comprehensive knowledge of PHC business and HRP implementation of Membership, Providers, Authorizations, claims, and Payment domains.
• Responsible for Transaction Management Service Desk functions.
• Manage HRP Production schedules and its Transaction Management support functions.
• Collaborate with the Phoenix Team to support HRP System upgrades.
• Engage with the HRP Configuration team to support and implement regulatory requirements.
• Lead projects and initiatives as assigned.
• Develop policies and procedures to document team standards.
• Create and maintain documentation for all projects.
• Maintain advanced proficiency in Oracle, Java, WebSphere, APIs, HRP System, PHCODS, and its implementation.
• Conduct regular meetings with business partners to ensure alignment with business objectives.
• Coordinate with other IT units, including Data Warehouse, EDI, Web Applications, and Operations, to maintain consistency across systems, services, integrations, and projects.
• Provide regular updates to the IT leadership Team regarding all activities and issues.QualificationsEducation and ExperienceBachelor's degree required or Master's degree preferred in Computer Science, Business, or a related field. At least twelve (12) years of IT experience in developing, implementing, and supporting software systems. At least eight (8) years of experience in a lead or management role, with at least five (5) of those years within an IT department. Three (3) plus years of managing a claims system with Java, Oracle, and UNIX experience. At least five (5) years of experience in a healthcare environment is required. Demonstrated experience in leading large, complex projects. Experience with a variety of project/process management tools and methodologies (e.g. Agile, Scrum, Kanban, Waterfall, and Lean).Special Skills, Licenses and Certifications8 Years of experience in Java 8, Apache Camel, Spring Boot, XML, Maven, Web Services (SOAP/REST), Apache ActiveMQ/JMS, PL/SQL, Linux & Shell Scripting, WebSphere, Web servers, AppDynamics. 8 Years' experience in Oracle or SQL Server.Performance Based CompetenciesStrong verbal and written communication skills are important, responsibilities will include extensive team and customer contact. Ability to quickly acquire in-depth knowledge of new systems and software configuration at PHC. Strong written and oral communication skills with the ability to interpret and understand technical requirements.Work Environment And Physical DemandsMore than 50% of work time is spent in front of a computer monitor.All Health Plan employees are expected to:
  • Provide the highest possible level of service to clients;
  • Promote teamwork and cooperative effort among employees;
  • Maintain safe practices; and
  • Abide by the Health Plan's policies and procedures as they may from time to time be updated.HIRING RANGE:$156,741.30 - $203,763.69IMPORTANT DISCLAIMER NOTICEThe job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.
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Keywords: Partnership HealthPlan of California, San Jose , Sr. IT Manager of Enterprise Applications - Claims System, Executive , Fairfield, California