File Maintenance Analyst

Job description

IBM Global Business Services (GBS) is a team of business, strategy and technology consultants enabling enterprises to make smarter decisions and providing unparalleled client and consumer experiences in cognitive, data analytics, cloud technology and mobile app development. With global reach, outcome-focused methodologies and deep industry expertise, IBM GBS empowers clients to digitally reinvent their business and get the competitive edge in the cognitive era in over 170 countries. Bottom line? We out think ordinary. Discover what you can do at IBM.

ROLES & RESPONSIBILITIES:

• Review and analyze CA-MMIS Operating instruction letters(OILs) and Problems.
• Add and update new codes to CA-MMIS Mainframe tables, files, and manuals and disseminate information on changes to impacted parties
• Work with CA-MMIS Release Management and Testing Team in implementing CA-MMIS table and file updates and minor programming changes.
• Maintain and update Medicaid Management Information System (MMIS) tables and table layouts, Procedure File (Current Procedural Terminology [CPT] and Healthcare Common Procedure Coding System [HCPCS] service codes) and Diagnosis File (International Classification of Disease, 9th Revision [ICD-9] coding)
• Create and modify CA-MMIS claims edit/audit criteria with instructions to allow claims examiners to adjudicate suspended claims as per policy.
• Participate in policy clarification sessions and work with DHCS to collect and define data, determine impact to existing systems due to policy changes and regulatory needs and document the impacts.
• Act as a liaison between DHCS and technical solutions groups, using strong communication skills to elicit, document, analyze and validate business processes, systems, and solution requirements.
• Understand the system impacts, business process modeling of current state and desired future state processes, perform ambiguity analysis and ensure consistent understanding across users, developers and testers.
• Provide requirements and design estimates of the work effort required to fulfill the requirements using the IBM Rational DOORS tool.
• Apply the knowledge of the claims system data model and Medicaid Architecture based on MITA to ensure the solution requirements are in alignment with regulatory framework.

BENEFITS
Health Insurance. Paid time off. Corporate Holidays. Sick leave. Family planning. Financial Guidance. Competitive 401K. Training and Learning. We continue to expand our benefits and programs, offering some of the best support, guidance and coverage for a diverse employee population.
https://www-01.ibm.com/employment/us/benefits/2019_Benefits_and_HR_Programs.pdf

CAREER GROWTH
Our goal is to be essential to the world, which starts with our people. Company wide we kicked off an internal talent strategy program called Go Organic. At our core, we are committed to believing and investing in our workforce through: Skill development: helping our employees grow their foundational skills Finding the dream job at IBM: navigating our company with the potential for many careers by channeling an employee's strengths and career aspirations Diversity of people: Diversity of thought driving collective innovation

CORPORATE CITIZENSHIP
With an employee population of 375,000 in over 170 countries, amazingly we connect, collaborate, and care. IBMers drive a corporate culture of shared responsibility. We love grand challenges and everyday improvements for our company and for the world. We care about each other, our clients, and the communities we live, work, and play in!
http://www.ibm.com/ibm/responsibility/initiatives.html http://www.ibm.com/ibm/responsibility/corporateservicecorps

CAMMIS

Auto req ID

208257BR
Required Education

High School Diploma/GED
Role ( Job Role )

Business Analyst
State / Province

CALIFORNIA
Primary job category

Technical Specialist
Company

(0147) International Business Machines Corporation
Contract type

Regular
Employment Type

Full-Time
Is this role a commissionable/sales incentive based position?

No
Travel Required

No Travel
IBM Business Group

GBS
Preferred Education

Bachelor's Degree
City / Township / Village

SACRAMENTO
EO Statement

IBM is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. IBM is also committed to compliance with all fair employment practices regarding citizenship and immigration status.
Required Technical and Professional Expertise

·  Minimum two years completed toward bachelor's degree in business, IT, healthcare, or related field; completed bachelor's degree preferred
·  Minimum two years experience as an Apprentice BA or equivalent position in mainframe and non-mainframe application development with increasing responsibility
·  Working knowledge of Medicaid/Medicare regulations/standards and industry standards and best practices
·  Minimum two years experience in a work area relative to the assignment
·  Ability to communicate effectively through clear, concise, written documentation, verbal presentations, and interviews
·  Ability to work in team environment
·  Previous Healthcare experience
Country/Region

United States
Preferred Technical and Professional Experience

·  None
Secondary Job Category

Services Specialist
Eligibility Requirements

·  None
Position Type

Professional
Early Professional Track

Not Applicable - Professional Hire
New Collar Role

Yes