Job Description

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:

* Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

* Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

* Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

* Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

Skills / Requirements

JOB SUMMARY 
The RPA Developer at Community will be responsible for the design, develop, test, and maintain of the Robotic Process Automation (RPA) solutions integrated with Optical Character Recognition (OCR) technologies. This role will also focus on leveraging automation to streamline processes, enhance operational efficiency, and reduce costs, with a particular emphasis on healthcare payer operations, ensuring compliance with industry standards and regulations.

JOB SPECIFICATIONS AND CORE COMPETENCIES
Development 
Design and develop automation workflows using low code automation platforms and intelligent document processing tools that can use structured and unstructured data and integrate with other platforms to perform work. Work closely with cross-functional teams, including business analysts, developers, and compliance, to ensure seamless implementation of automation solutions. Solutions must comply with HIPAA, CMS regulations, and healthcare data security standards.
 

Maintenance
Maintain and enhance existing automation scripts while monitoring their performance in meeting business needs. Ensure all automations can monitored and reported on for effectiveness and maintenance. Keep the core platforms current according to vendor recommendations and Community Health Choice standards.
 

Collaboration
Collaborate with stakeholders to identify opportunities for automation and build business cases to help leaders understand the anticipated value of the work. Participation in team discussions such as architectural and development design review and provide training and support to teams on tools and best practices.
 

Documentation
Develop detailed design documents and as-built technical documents for each automation activity. Document and maintain records of automation workflows, changes, and approvals to align with audit and compliance requirements. Gather and document functional and technical requirements for identified solutions.
Other duties as assigned

Reports to Position Title: Director, IS System Applications


QUALIFICATIONS: 
Education/Specialized Training/Licensure: 

Bachelor's degree in computer science, Information Technology, or a related field or Eight (8) years of equivalent experience in lieu of degree required.

Work Experience (Years and Area): 

  • 4+ years administrating or developing technology with at least 3+ years of experience with RPA tools (i.e.., UiPath) and 
  • 2+ years of experience with OCR technologies required. 
    Experience with healthcare payer systems preferred.
    Knowledge of healthcare standards such as HIPAA and EDI formats (e.g., 835, 837) preferred.
    Background in scripting or programming languages such as Python, JavaScript, C# preferred.

    Management Experience (Years and Area): N /A 

    Software Proficiencies: Microsoft productivity tools, knowledge of core base technologies such as SQL, AD, REST/SOAP APIs, JSON required.

    Visio, Azure DevOps, ServiceNow preferred.

    Other:
    Attention to detail and focus on quality 
    Adaptability and eagerness to learn new tools and technologies.
    Proactive mindset to identify and act on automation opportunities.
    Strong organizational and prioritization skills 

    COMPETENCIES
    Impact & Influence + Strategic Vision, Profitable Growth (Supervisory Employees)
    People and Team Development, Employee Empowerment (Supervisory Employees)

    Job Family/Job Title Competencies
    Attention to Detail
    Problem Analysis

    List of additional competences
    Hands-on experience in administration, development, and implementation of the RPA and OCR platforms.
    A solution focused problem solver with solid troubleshooting skills.
    Excellent collaboration, communication, and presentation skills.
    A strong desire to learn new technologies and a passion for creating solutions to solve business needs.
    Strong understanding of Agile methodologies, including Scrum and Kanban or other iterative approaches. Experience with Azure DevOps would be a plus.
    Understanding of ITIL ITSM processes 
    Understanding of cloud platform multiple instance design and administration.
    Drive quality development with techniques such as test-driven development, mastered data, automation, design reviews, etc. 
    Understanding of and desire to implement best practices in coding and design as per industry standards and community guidelines.

    INTERPERSONAL SKILLS 
    Strong team player with ability to work independently with minimal supervision. 
    Able to foster sense of team ownership for commitments and work with peers to ensure delivery targets
    Mentoring mentality that promotes platform adoption and knowledge transference.
    Able to communicate with individuals in a tactful, congenial, and personal manner.
    Able to accept and apply learnings from individual and/or team mistakes.

Application Instructions

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