Clinical Systems Administrator

Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you. Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

• Sets up, maintains and protects the integrity of the system administration module, config tables and config catalogs for the medical management application
• Coordinates system changes, including tables, options, programing of sentinel rules, and guidelines and oversees system testing to make sure systems are working as expected.
• Works with various IS and vendor project managers to coordinate creation and successful migration of enhancements and system upgrades
• Supports, maintains and updates correspondence in Client Letter for existing and new business
• Provides assistance to medical management training efforts, including training development and training delivery, as needed.
• Coordinates system auditing to confirm performance levels and identify potential areas for further investigation.
• Evaluates system reports, identifies/coordinates investigation and intervenes to resolve issues.
• Sets up, maintains, updates, as needed, provider portal rules and trigger tools. Maintains the integrity of the rules engine. Assist with training and support of the provider portal users.

• Bachelor's Degree required.
• Registered Nurse preferred.
• Demonstrated ability to identify trends and conduct root-cause analyses.
• Ability to provide constructive feedback with a focus on improved quality.
• Ability to communicate in a positive/professional manner both orally and written.
• Ability to follow detailed instructions with a high degree of accuracy.
• Ability to work independently; complete tasks in the allotted time frame.
• Strong problem solving skills and decision making skills.
• Teamwork & teambuilding, decision making, and organizational effectiveness.
• Utilization and Case Management experience, Business Experience (Insurance, Healthcare, Finance, Medical Systems).
• Programing experience required
• Working knowledge of Facets, SIR, Rightfax and EXP
• Proficient PC skills in a Windows based environment (excel, word, access database)
• Sound Personal Management Skills
• Demonstrated knowledge of plan benefit information and managed care (preferred)
• System administration experience preferred
• Good interpersonal, personal skills preferred
• Strong oral and written communication preferred
• Understanding of Compliance and Confidentiality information
• Ability to manage system admin support functions
• Ability to manage system admin advanced functions preferred
• Project lead preferred
• Informed decision making processes, including the utilization of data preferred
• Abilty to work with a limited number of vendors preferred
• Ability to work with a multiple vendors preferred