EPIC PROVIDER RELATIONS ANALYST in San Diego, CA at Scripps Health Plan Services -4S Ranch

Date Posted: 10/4/2018

Job Snapshot

Job Description

At Scripps Health, you will experience the pride, support, respect that has been repeatedly recognized as one of the nation’s Top 100 Places to Work.
You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.
Join a winning team supporting the Provider Relations department. Working together, you’ll bring your Managed Care expertise, compassion, and excellence to all we do. The ideal candidate will thrive in a fast paced environment, display self-motivation and enjoy providing world class customer service.
The Epic Provider Relations Analyst is a liaison between the Health Plan, Providers and Scripps Health. They will Configure professional and institutional vendors within the Epic Tapestry module; including associating vendors with providers, and places of service.  Analyzing workflows supporting provider configuration, ensure accuracy of utilization management, provider steering, and claim adjudication. Develops processes for validation, analysis, and QA of vendor, provider and contract configuration. Knowledge provider contracting, claims and managed care operations.  Make recommendations to management regarding system enhancements needed and communicates system problems relative provider contracting. Performs problem resolution of configuration issues received via email, fax, returned mail and other sources including resolution of Customer Relationship Management (CRM) that are for provider, vendor and place of service configuration.
The Epic Provider Relations Analyst, under general direction, participates on cross functional, integrated teams to troubleshoot complex problems across multiple domains. Designs, builds and tests system configuration. Translates business requirements into technical solutions. Conducts quality reviews of system builds. Upcoming projects for this team will include implementation of Apogee MSOW and Electronic fund transfers.
This is a Full Time, Salaried position, located at Scripps Business Services office in the 4S Ranch area of San Diego.

Job Requirements

Required Education/Experience/Specialized Skills:
  • Excellent critical, analytical thinking and customer service skills.
  • Knowledge of at least one of the following: membership, benefits, provider contracts & pricing, medical reviews, referral authorizations and code review and fee schedules.
  • Experience with Electronic Health Record systems, preferably Epic.
  • Advanced knowledge in health care delivery from either/both a payor or provider perspective, EDI and paper claim lifecycle, along with health insurance industry practices and standards.
  • Exhibit excellent written and verbal communication skills
  • Advanced troubleshooting skills
  • Excellent organizational and project management skills
Preferred Education/Experience/Specialized Skills/Certification:
  • Epic Certification. Preferably in Tapestry, Benefits, CareLink or MyChart.
  • Has led small projects or technical activities
  • Experience as a configuration analyst / business analyst or healthcare or managed care (such as claims adjudication)
  • Bachelor’s degree.
Scripps Health is repeatedly named on the Fortune Magazine’s 100 Best Companies to work for, only San Diego-based company and Becker’s Healthcare Top Hospitals. Scripps Health offers a robust Total Rewards Program designed to compensate and motivate you throughout your career. Scripps Health Total Rewards Program includes a broad range of plans and programs including market competitive pay and performance incentives, health and wellness benefits, financial wellness benefits, work-life resources, learning and development opportunities, and rewards and recognition. Unlock your potential with Scripps Health today.

Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, age, status as a protected veteran, among other things, or status as a qualified individual with disability.