Responsible for overseeing the Configuration and system changes for the claims adjudication
and case management systems. Responsible for maintenance and enhancement of system
configuration and related database tables, documentation and support of Partnership Health Plan
of California’s (Partnership) EDI related functions, testing and assisting in documentation of
changes to the system software configuration using a variety of computer software packages to
meet Partnership needs. Maintains the implementation calendar, version control and completion
of approved change requests. Works as a liaison with IT and EDI, and serves as the point of
contact with software vendors and consultants. Provides overall project support for planning,
implementation, testing, and coordination of configuration enhancement work plans. Develops
reports and presents information to all levels of Partnership leadership. Provides leadership,
coaching, and for assigned Partnership projects and programs. Develops reports and presents
information to all levels of Partnership leadership. Provides leadership, coaching, and
coordination for assigned Partnership projects and programs.

 Provides daily direction to direct reports and is responsible for management, including
timecards, performance discussions, mentorship, and development plans.
 Assigns workload and monitors performance, evaluates priority level and makes changes as
necessary.
 Reviews State of Medi-Cal policy and CMS/Medicare updates and provides direction on
system changes required to ensure Partnership’s compliance with all policy requirements.
 Oversees the configuration input, testing and go live processes.
 Attends and represents Partnership at various system user groups and trainings.
 Collaborates with System vendors and SME’s to problem-solve and design solutions.
 Responsible for maintaining an efficient, complete system to store all changes and updates
completed in each system.
 Analyzes, tests, and makes feasibility recommendations on impact of proposed system
configuration enhancements in accordance with Partnership benefits and policies.
 Responsible for monitoring the distribution of the workload and meeting production and
quality standards.
 Contributes to the employee training program, and maintains tools and resources in a
current manner.
 Responds to and provides documentation for internal and external audits.
 Participates in various organizational wide projects and committees.
 Other duties as assigned.

All HealthPlan 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 HealthPlan’s policies and procedures as they may from time to time be updated.

HIRING RANGE:

$136,296.78 - $177,185.82

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, education 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, or work environment change.