Health Plan Configuration Analyst - Near Providence RI
- Job Title
- Health Plan Configuration Analyst - Near Providence RI
- Requirement ID
- 27715904
- Begin Date
- 11/1/23
- Duration
- Location
- Providence, Rhode Island Area, 02908
- Other Location
- Description
-
Job description – Configuration Analyst
Please send replies to: jobs@sourcedge.com
Primary Responsibilities:
• Ability to demonstrate the core values of - Integrity, Compassion, Relationships, Innovation, and Performance
• Acts as the Health Plan subject matter expert with end-to-end configuration and controls associated with transactional processing
• Prepares all the required documentation and submits to the necessary parties to implement new products, enhance existing products, or implement new system functionality
• Manages and performs the daily operational activities and/or project activities which may be identified through daily work assignment or project assignment
• Participates on all internal or external calls related to configuration control
• Acts as the primary contact to provide answers, perform research or any other activities required to answer questions in a timely manner
• Acts as the liaison between business and department to obtain information or answer questions
• Provides subject matter to develop and execute end-to-end user test cases related to validate benefit configuration and controls
• Identifies issues that may occur within the testing process and provide resolution in a timely manner to ensure critical project timelines are met
• Escalates issues with manager and business when required to resolve issues or meet critical timelines
• Develops and provides documentation as required to other team members
• Performs walk-throughs of configuration design and testing results to obtain necessary approvals to move forward into implementation
• Validates implementation in production ensuring configuration and controls are working as required
• Proactively takes the initiative to expand knowledge of a Health Plan database
• Obtains, reviews, and validates daily reporting to note any issues and undertake the necessary actions to resolve
• Develops, writes, and manages associated procedures, manuals, and documentation
• Identifies and writes new procedures or updates existing procedures
• Is the lead subject matter expert and holds the primary relationship with peers and business
• Is the primary contact to open and log all operational and project issues related to configuration
• Embraces culture of growth, change, and continuous learning
• Mentors and coaches for the development of others and actively pursues opportunities for enhanced knowledge on Health Plan and supporting applications
• Reporting risks that are identified to the appropriate team and/or management
• Additionally, responsible for managing, monitoring, and reporting risks within the scope of your work area, to include, but not limited to Information Security risks
• Checking information and picking up inconsistencies and mistakes with themselves and others
• Work in an Agile environment to create User Stories and Tasks from analysis through implementation ensuring needs are captured and delivered
• Supports others in their time planning and organizing
• Handle new system configuration setups with large and complex scope, including most difficult or advanced problems
• Can work through difficult circumstances affecting key relationships
• Regularly works on tasks that are varied and complex. Applies full range of specialized skills and job knowledge; frequently adapts procedures
Required Qualifications:
• Recent Health Plan front end product Build experience with Facets or Amisys or HealthRules or Other with knowledge of (product, service payment, service rules, supplementals, limits, accums, etc.)
• Experience building Product from Front End Health Plan and Back End Health Plan
• Proven experience creating allowable professional, Inpatient hospital and Outpatient facility claims via a Health Plan
• Experience using Paper Build documents
• SQL querying experience with Health Plan in claims, benefit, and product backend tables
• Unit test and change validation experience
• Proven experience in reading Benefit Summary documents and determine Product and Benefit configuration
• Proven ability to work in quickly and efficiently in an environment where priorities and tasks may shift
Preferred Qualifications:
• Experience with Health Plan CMU
• Experience with Agile methodologies
• Knowledge of Workflow and how it is used for benefit configuration
- Required Skills
-
Configuration Health Plans
Amisys
FACETS
QNXT
HealthRules
- Openings
- 1
