Information Technology QualCare, Inc., a progressive and successful managed care organization, is currently seeking the following positions: Director, IT Operations Responsibilities include leading the IT Operations and Helpdesk teams in delivering data and application support services on a daily basis for business-critical production health care application and environments. The position will work as part of a team to support a full range of data service functions and application support, including but not limited to, coordinating and executing data service process, procedures and services; executing and monitoring operational reports. The ideal candidate will develop, maintain, and produce governance metrics for all Data Services; drive operational excellence through process improvement; work with stakeholders to define business and system requirements for new data service implementations. Requirements for this position include BS in Computer Science/Management Information Systems or equivalent; minimum 5 years experience IT support; 5 years of progressive leadership experience, excellent commutation skills; demonstrated ability to challenge inefficient processes and execute on improvements.
Network Administrator, IT Responsibilities include providing both technology and operational leadership for QualCare’s server and network infrastructure. This will include developing and maintaining a consistent, flexible and reliable server environment which facilitates project delivery, agility, and operational efficiency. This position will also provide day-to-day operational support of the environment including: new systems delivery, change requests, proactive availability and performance monitoring, preventative maintenance, troubleshooting and the resolution of systems issues. The Network Administrator also partners with other team members in defining technology strategy, standards, best practices, and top quality operational processes for the QualCare server and network environment.
Requirements include experience building and supporting a production Windows Server 2003/2008 environment of approximately 150 servers; Windows Active Directory in a multi-site environment, including design and implementation of AD forest and domains; designing and implementation and support of Citrix ZenApp and XenDesktop; maintaining Server hardware; excellent communication skills; Bachelor’s degree in Computer Science or equivalent experience, Server Admin or MCITP. Operations Analyst, IT Responsibilities include providing application support services on a daily basis for businesscritical production health care applications and environments. The position will work as part of a team to perform a full range of data service functions and application support, including but not limited to, coordinating and executing data service process, procedures and services; executing and monitoring operational information reports utilizing Crystal Reports and Business Objects; provide governance metrics for all Data Services by tracking and producing operational reports for management. Requirements for this position include, BS in Computer Science/Management Information Systems or equivalent; minimum 2 years experience IT support; excellent written/verbal commutation skills; ability to multi-task and manage competing priorities in a production support environment; MS Excel, Access, SQL, PowerPoint, Visio, T-SQL, scripting and/or programming language fundamentals and Business Objects.
Database Engineer, IT Responsibilities include all aspects of the design, development and delivery/implementation of data and database solutions. Requirements include a Bachelor’s Degree in Computer Science or related field; 6-8 years experience in data solutions development working with SQL Server and Crystal Reports 2008, strong knowledge and experience with database tuning, ETL, DTS, T-SQL, SSIS and business intelligence technologies; excellent communication skills, problems solving and analytical skills are required. Manager, Provider Reporting Responsibilities include reviewing, evaluating, designing, and implementing and maintaining databases through the analysis of healthcare information obtained from a variety of sources including but not limited to patient care, financial and demographic data. The Manager of Provider Reporting will also be responsible for planning and scheduling project timelines and providing direction and support to the team.
Requirements for this position include a Bachelor’s Degree; minimum 4 years experience in managed care or related field with management and project management experience; ability to manipulate and synthesize large amounts of data, conduct impact analysis and summarize results for recommendation; advanced knowledge of MS Access, Excel and proficiency in of MS Word, PPT, SQL and Business Objects; excellent communication problem solving skills. Director, Community Care Management Responsibilities include supporting our ACO (Accountable Care Organization) Initiative. This position will design and implement methods to support QualCare’s ACO initiative in the areas of caremanagement/coordination, member engagement, improvement of quality, utilization, and cost metrics, and reporting of required data. Additional responsibilities include meeting with clients on a regular basis and analyzing reports/data for performance improvement and overseeing a team of Community Case Management Nurses.
Requirements for this position include a current RN license; Bachelor’s degree, Master’s degree preferred; management experience that includes a comprehensive Performance Improvement program; experience with Medicare’s Physician Quality Reporting System/Initiative (PQRS/PQRI) and experience with physician’s office practices preferred; high level proficiency in Excel and Business Objects; excellent communication and presentation skills are also required. Data Analyst, Performance Improvement Reporting to the Director of Performance Improvement, this position supports QualCare’s ACO (Accountable Care Organization) Initiative. Responsibilities for this position include analyzing data and generating reports related to clinical data, utilization metrics and costs. Requirements for this position include Bachelor’s Degree preferred, Associate’s Degree required; data analysis experience with clinical performance data and statistical analysis experience preferred; high level of proficiency in Excel and Business Objects; excellent communication skills are also required.
Data Analyst, Utilization Management Responsibilities include delivering thoughtful, accurate and timely data analysis. This position works with all levels of management and staff in developing and delivering accurate and timely information analysis, via Excel, and other related software application tools. Responsibilities for this position include generation and analyzation of weekly and monthly Disease Management reports, the analysis of UM data with regard to Finance reports, and the accurate analysis of data with regard to health care metrics. Requirements for this position include Bachelor’s Degree in Business or related field; 2-4 years of diverse database application experience (Oracle, Access, SQL, NT 2000, XP Operation Systems); knowledge of HTML, Visual Basic Script, and ASP ;Experience with Healthcare, Financial and Sales reporting; Advanced proficiency in MS Excel; Intermediate proficiency MS Access and MS Word.
Must have excellent communication HealthCare Account Management, Client Services Responsibilities include managing a designated client base for all areas of benefit plan administration. The ideal candidate will foster exceptional business relations with clients, address specific client issues, ensure that systems and processes are in place to meet client needs, and identify trends determined through report analysis. To achieve optimal client satisfaction this position identifies and profiles the performance of Client Health Plans, and provides consultative services in benefit plan design as well as legislative updates. Requirements include Bachelor’s Degree; minimum 3-5 years managed care experience; exposure to healthcare legislation; thorough knowledge of benefits and industry trends; ability to promote and retain positive business relations and anticipate and identify client needs; proficiency in MS Word and Excel; excellent communication and presentation skills.
This position also requires local onsite client visits. Medical Claims Examiner, Claims Responsibilities include the challenging responsibility of processing and adjudicating paper, electronic and scanned claims in order to meet targeted ratios. This position requires an excellent understanding of benefit plan designs in order to maintain compliance with established regulations. Requirements for this position include: a HS Diploma, min.
2 years experience processing and adjudicating medical claims in managed care environment; experience independently reviewing simple to moderately complex claims for adjudication purposes; as well as exceptional data entry skills. Customer Service Advocate, Customer Service Responsibilities include assisting Members and Providers regarding health benefit plans and medical claims reimbursement. You will provide timely and accurate responses and resolutions consistent with plan information. Requires a HS Diploma; 1-3 yrs previous exp.
as a Customer Service Representative in managed care/health care, and knowledge of benefit plan design. We offer a competitive wage and benefit package. Please apply online at: www.qualcareinc.com or mail/fax your resume, which MUST include salary history/requirements to: QualCare, Inc. 30 Knightsbridge Road Piscataway, NJ 08854 Attn: Human Resources Fax: 732-562-7780 Equal Opportunity Employer, M/F/D/V * Best Places to Work in NJ 2006, 2007, 2008, 2009, 2010 and 2012 CLICK THE IMAGE TO VIEW THE AD
Workplace Diversity - 13 months ago
QualCare is committed to providing its employees with an opportunity to be recognized for their exemplary contributions; achievements that a...