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System Configuration Analyst - Lake Oswego, United States - VanderHouwen
Description
System Configuration AnalystOur client is seeking a System Configuration Analyst to join their organization.
This position is responsible for providing system configuration for the organization's managed care payment system (QNXT) and other core vendor-developed systems at an intermediate level.
Ensures system configuration consistency across all core applications, including technical scoping, configuration, testing, and implementation. Participates in the vendor management discipline, supporting long-term vendor performance and strategy. Other core responsibilities include IS team and user collaboration, analysis, and documentation.This role is fully remote and open to candidates who reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin.
System Configuration Analyst ResponsibilitiesSystem Configuration
Configure and perform daily software maintenance with some management oversight to support the efficient administration and data integrity of multiple systems:
QNXT, including claims, utilization management, benefits, contracts, member, call tracking, fees and code modules.
Optum Claims Edit System.
TriZetto Enrollment Administration Manager.
Client Connect provider and member web portal.
Cactus provider credentialing.
Claim Test Pro.
Participate in objective decision making to maintain data integrity, alignment and usability of applications for multiple departments across the organization in line with organizational objectives.
Grow in identifying and articulating how the impact a configuration change has on upstream and downstream services and business workflows.
Assist IS leadership in IS governance, demonstrating progress learning how to evaluate and monitor applications to ensure they align with and sustain the objectives of the organization.
Participate in frontend and backend process testing and implementation of new software and software upgrades that supports the organization's strategic goals.
Perform advanced quality assurance testing to validate configuration behavior against established baselines, in keeping with contract, regulations, and customer requirements.
Develop and maintain appropriate configuration documentation related to configuration and processes; participate in developing policies and procedures.Collaborate with business teams to build accurate system process and training documentation for consistency with system configuration and workflows.
Collaborate with a variety of stakeholders with guidance from senior System Configuration Analysts or team manager.
Serve as the point of escalation following the service desk for users experiencing software functionality issues.
Assist operational departments with system functionality questions for current, new or emerging work.
Assist users in submitting comprehensive development and Change Control Board requests.
Assist software developers, production support, engineers and technicians with a variety of user, process and system needs, such as interpreting requirements for technical solutions and verifying deployed solutions meet the business need.
Support internal and external auditors to provide system configuration information.Participate fully and constructively in department meetings, department decisions and department growth.
Participate as an advance resource in interdepartmental workgroups, such as the Change Control Board, cost and utilization committees, and payment integrity program.
Maintain impartiality and upholds the objectives of the organization.Participate in software user groups, attend conferences to further education and establish relationships with peer organizations.
Research and Design
Conduct advanced research of software system enhancements and functionality.
Participate in assessing impact of system changes on the organization and interfacing systems.
Recommend software configuration that aligns with existing or new business requirements as identified by IS or operations teams.
Review and interpret provider contracts for accuracy and assess ability to administer.
Research and interpret CMS, OHA and federal and state regulations with manager guidance.
Retain knowledge and remain abreast of relevant State and Federal laws and regulations relating to the medical health insurance industry and the Medicare and Medicaid industry.
Consult with operational departments to determine needs and propose solutions in terms of system design and implementation.Research and advise users on best practices of system utilization.
Identify situations where configuration alone cannot meet business requirements and participate with operational areas to develop supporting processes.
Vendor Coordination and Relations
Submit detailed, concise system functionality incidents to software vendors using their service software.
Develop and maintain effective working relationship with vendors to communicate business needs, identify defects, and resolve system functionality gaps.
Monitor reported issues and escalate serious issues or delays to management.
User Security Administration
Provision user security access for numerous software applications following policies and procedures of client, vendor or business partners.
Understand software usage and user's position responsibilities sufficiently to identify when access is not in keeping with HIPAA minimum necessary protocol.
Consult with manager regarding new and challenging access requests.Conduct regular audits of user security audits.
Organizational Responsibilities
Perform work in alignment with the organization's mission, vision and values.
Support the organization's commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
Strive to meet annual business goals in support of the organization's strategic goals.Adhere to the organization's policies, procedures and other relevant compliance needs.
Perform other duties as needed.
System Configuration Analyst Qualifications
Minimum 3 years' experience in system configuration or progressively responsible experience in areas that integrate with configurations such as claims processing, coding, auditing, billing, or encounter data.
Preferred2 years' experience in claims processing, coding, or auditing.
1 year experience in health plan system (e.g., QNXT, Facets, Tapestry, etc.) or provider revenue system.
Knowledge, Skills and Abilities Required
Computer applications skills (claims payment, Excel, Word, Outlook).
Computer programming concepts and practices.
Medicaid and Medicare benefit plans.
ICD, CPT, HCPCS and other national coding systems.
Claims operation practices and protocols.
Principles and practices of managed care systems, procedures, and plan products/systems.
System plan/benefit building and maintenance.
HIPAA regulations and compliance.
Computing/applying rate calculations, and resolving rate calculation disputes.
Benefits
Benefits are available to eligible full-time employees and include coverage for medical, dental, vision, life insurance, and 401k plans.
About VanderHouwen
VanderHouwen is an award-winning, Women-Owned, WBENC certified professional staffing firm. Founded in 1987, VanderHouwen has been successfully placing experienced professionals throughout the Pacific Northwest and nationwide. Our recruitment teams are highly specialized in either Technology and IT, Engineering, or Accounting and Finance career markets.
Our recruiters value building meaningful, professional relationships with each candidate as well as developing honed knowledge of companies' staffing needs and workplaces.
Partner with us to land your next exciting career.VanderHouwen is an Equal Opportunity Employer and participates in E-Verify.
VanderHouwen does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state or federal civil rights laws.
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