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CareSourceCA

Operations Application Developer II

CareSource is a nonprofit managed care organization based in Dayton, Ohio, that serves over 2 million members with a wide array of Medicaid and Medicare products.

CareSource

Employee count: 1001-5000

Salary: 71k-113k USD

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Job Summary:

The Operations Application Developer II designs, codes, tests and analyzes software programs.

Essential Functions:

  • Design, develop, and implement custom code and enhancements within the Facets core module
  • Apply expertise in SQL scripting and Real-time development skills to analyze data and develop solutions
  • Build and support claims integrations between Facets and external systems or data sources.
  • Troubleshoot and resolve the providers load, claims processing and billing issues, performing root cause analysis, and applying technical fixes
  • Interpret complex business rules and translate them into effective, scalable Facets development solutions.
  • Participate in testing and validation of custom code to ensure accurate claims adjudication and output.
  • Support production environments, provide post-deployment monitoring, and address any performance or functionality concerns
  • Recommend, schedule, and perform software improvements and upgrades
  • Consistently write, translate, and code software programs and applications according to specifications
  • Perform technical code reviews of peers to ensure proper coding methodology is being adhered to
  • Perform any other job duties as requested

Education and Experience:

  • Bachelor’s degree in computer science or software engineering or equivalent years of relevant work experience required
  • Minimum of five (4) years of advanced OOP principles and design experience required
  • Experience developing and designing n-tier applications with multi-tier architectures is preferred
  • Facets Extension development or experience developing applications in the healthcare sector preferred
  • UML Modeling experience is preferred

Competencies, Knowledge and Skills:

  • Working technical knowledge of object-based programming languages, including C#, VB.NET, ASP.NET, or Python
  • Expertise in SQL development using Stored Procedure and complex queries
  • Knowledge of EDI 837, 835 and 834
  • Strong hands-on development experience with Core TriZetto Facet Framework and with Facets Schema
  • Proven expertise in Claims Adjudication and Processing
  • Expert in TriZetto Facets core modules such as Enrollment, Provider, Utilization Management
  • Good understanding of Workflow configuration, Benefit and Pricing configuration
  • Strong knowledge of integrated development environments, including SVN, Microsoft Visual Studio, Team Foundation Server
  • Knowledge of applicable data privacy practices and laws
  • Strong understanding of software development life cycle, especially Agile, Test Driven Development, and Waterfall
  • Familiarity with TDD and Iterative software development methodologies
  • Flexible and adaptable in regard to learning and understanding new technologies
  • Strong written and oral communication skills
  • Strong interpersonal skills
  • Highly self-motivated and directed
  • Proven analytical and problem-solving abilities
  • Ability to effectively prioritize and execute tasks in a high-pressure environment
  • Ability to work both independently and in a team-oriented, collaborative environment
  • Ability to work additional hours to meet project deadlines

Licensure and Certification:

  • Certifications in technical tools and/or programming languages preferred (MCSD, Java, Onbase, Tibco, SAP, etc.)
  • Certification in Trizetto Facets product preferred

Working Conditions:

  • General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$70,800.00 - $113,200.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

  • Create an Inclusive Environment

  • Cultivate Partnerships

  • Develop Self and Others

  • Drive Execution

  • Influence Others

  • Pursue Personal Excellence

  • Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Mid-level

Salary

Salary: 71k-113k USD

Location requirements

Open to candidates from all countries.

Hiring timezones

Worldwide

About CareSource

Learn more about CareSource and their company culture.

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CareSource is a nonprofit, nationally recognized managed care organization established in 1989 that has grown to serve over 2.1 million members across various states in the U.S. With its headquarters in Dayton, Ohio, CareSource administers one of the largest Medicaid managed care plans in the country. The organization offers a wide range of health insurance products, including Medicaid, Medicare Advantage, and Health Insurance Marketplace plans. CareSource stands apart by addressing the social determinants of health which significantly impact the well-being and health outcomes of its members. This mission-driven approach enables them to provide personalized care solutions that cater to the unique needs of low-income and vulnerable populations.

As part of its commitment to innovative care delivery, CareSource continually enhances its services through technology and partnerships designed to streamline access to care and improve member experiences. The organization employs nearly 5,000 individuals who are dedicated to fostering community relationships and ensuring that every member receives high-quality care when needed. Their strategic initiatives focus on improving health outcomes, operational excellence, and social equity within the healthcare realm. In addition to traditional medical services, CareSource actively engages in health education and outreach efforts that foster resilience and self-sufficiency in the communities they serve. This approach contributes to a broader aim of not just treating illness but promoting overall health and wellness in society.

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CareSource

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