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.
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
regulation
Job Responsibilities:
25% 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.
25% 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.
25% 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.
20% 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.
5% Other duties as assigned
Reports to Position Title: Director, IS System Applications
Employees Supervised Titles: N/A
QUALIFICATIONS: Required
Education/Specialized
Training/Licensure:
Work Experience (Years and Area):
Software Proficiencies: Microsoft productivity tools, knowledge of core base technologies such as SQL, AD, REST/SOAP APIs, JSON, Visio, Azure DevOps, ServiceNow
Preferred:
• Experience with healthcare payer systems
• Knowledge of healthcare standards such as HIPAA and EDI formats (e.g., 835, 837).
• Background in scripting or programming languages such as Python, JavaScript, C#
Additional Competencies:
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