You can make a difference in people’s lives every day. When you join UCLA Health, you’ll be working at an institution that provides leading-edge care to the people of L.A. and throughout the world. We provide our team members with the environment and support to do amazing work, because each and every one of them plays a vital role in our commitment to care.
Take on a significant role within a world-class health organization. Elevate the operational effectiveness of a complex health system. Take your professional expertise to the next level. You can do all this and more at UCLA Health.
As a key member of our Medicare Advantage Operations team, you will develop detailed requirements specifications to meet our business needs. This will involve working directly with and serving as a liaison between business units, external trading partners, IT, and support teams. You will:
- Ensure functional and non-functional requirements are understood and implemented
- Perform testing, design, and delivery requirements
- Identify, analyze, quantify, and mitigate business risks
- Deliver and update training documentation
- Generate ad hoc reports to support the operations team
We’re seeking a self-motivated, adaptable, customer-focused, results-driven individual with:
- Required Bachelor’s degree in business, information systems, healthcare, or a related field
- Five or more years of experience managing enrollment, claims, or encounters in a Medicare or managed care environment required
- Five or more years of experience with CMS processes required
- Computer proficiency with Microsoft Office, SQL, and data visualization tools
- Knowledge of encounter regulatory reporting and compliance requirements
- Experience managing vendors to contractual requirements
- Ability to research and resolve encounter issues
- Understanding of the healthcare model, capitation, and other managed care IPA and provider reimbursement methodologies
- Knowledge of physician/facility billing practices, CPT coding initiatives, ICD-10 coding standards, and revenue and HCPCS coding
- Strong leadership, interpersonal, analytical, problem-solving, and prioritizing skills
- Excellent oral and written communication skills
- Ability to develop, implement, and evaluate methods and systems to improve efficiency
- Ability to work well independently as well as part of a team
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We are also home to the David Geffen School of Medicine, a highly respected leader in the development of breakthrough medical research and outstanding clinical professionals. If you’re looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
EMPLOYMENT SCAM ALERT:
UCLA Health Recruitment is currently being targeted by scam artists through external job board sites. Review some tips in order to avoid becoming targeted. El reclutamiento de salud de UCLA actualmente está siendo atacado por estafadores a través de sitios de juntas de trabajo externos. Revisar algunos consejos para evitar ser apuntado.
“The environment is nurturing and fosters growth. When I come to work, I know what I'm doing matters.”
VINCENT, Sr. CLS Specialist, Toxicology
MONICA
I've been blessed to touch so many lives through my serving. It's a privilege to uplift other employees with words of encouragement and a smile.
SOZIT
The first thing i noticed when i joined the team was how everyone is very welcoming and friendly with supportive management. I did not feel like an outsider.
EDGAR
Once I joined, I knew UCLA Health was THE place to be due to the growth potential and training offered
RENE
If you want to grow professionally, this is the right place for you.
ERA
We are family here. We support each other. We collect together.
ELIZABETH
It’s so diverse and inclusive here. There’s always the opportunity to share your thoughts. It's a place where you feel you belong.
JERRY
Your career path at UCLA Health will enable you to follow a myriad of avenues and turns. It opens up a wide variety of opportunities.
ORLANDO
There’s a togetherness and higher level of commitment to teamwork at UCLA Health. We are several groups and teams that work together with a common goal which is to improve our patients experience.
DAVID
UCLA Health walks the walk and talks the talk! It's an incredible feeling to work for an organization that always puts the patient first. I am honored to work in full alignment with the UCLA Health Mission and Vision.
DR. ISLA GARRAWAY
UCLA has incredible resources and a team science approach. The ability to work with collaborative teams and access the amazing resources around campus is the best part about being at UCLA.
RADU
UCLA is very diverse in its personnel as well as its many research fields studied
JENNA
UCLA Health provides so many opportunities to exchange ideas, share moments and grow. I have learned a lot about team management and relationship building.
SHARON
I was looking for a job to further my career and continue to improve and learn as a therapist.
TARO
I have been blessed to be surrounded by supportive colleagues who aspire me to be the best version of myself.