- Collaborate with business areas to understand financial impact to the organization for approved Medical Cost Action projects
- Triage, research, and resolve escalated issues within industry standard timeframes to meet service level agreements
- Responsible for identifying areas of unused/underutilized system functionality to support business initiatives
- Perform post-implementation audits to ensure configuration aligns with current business requirements and process
- As required, facilitate and lead meetings and selected workgroups
- Mentor and train Configuration Analysts on configuration best practices
- Assist management in in onboarding new hires, acting as onboarding buddy, and leading training sessions
- Assist management with oversight of augmented staff by tracking performance, escalating issues, etcServe as a key resource in facilitating the gathering of business and technical requirements in addition to test cases for all configuration changes
- Work with corporate project stakeholders and Business Analyst to formulate and communicate business requirements and scope of project
- Work with various business areas at different levels within the organization to translate business requirements into technical specifications documents and also act as liaison to translate technical questions and processes into a format the business can understand
- Analyze business requirements and objectives and perform system configuration analysis, design, coding, and unit testing following established processes, standards and procedures
- Develop and maintain a library of standard operational procedures for all configuration tasks, including but not limited to creating and configuring benefit plans using best practice
- Execute the build and implementation of benefit plan adjudication rules
- Perform all configuration changes within multiple test environments, coordinating with testing and project teams to establish timelines and project planning in an effort to maintain the integrity of the environment in use
- Responsible for configuration in depth research, review, and creation of claims data to validate configuration output is performing as expected
- Handle the change control process when configuration results do not match expected outcome, partners with Business Analyst and Testing team to find solutions as needed
- Develop and execute multiple unit test cases and complete Configuration Control Framework documentation to support configuration audit requests
- Act as a liaison between business stakeholders and technical teams to validate and translate unit, positive, negative and regression testing results and any remediation necessary
- Coordinate and document all configuration activity for change control and auditing
- Responsible for coordination of production turnover of all configuration work upon business owner sign off as well as post-production validation
- Responsible for the Configuration Management Promotion process for HealthRules, Optum CES, and Burgess Source and other systems as needed
- Serve as subject matter expert for root cause analysis and issue resolution, by providing guidance on system limitations and functionality
- Develop proof of concepts prototype configuration to support business requirements and develop documented solutions and processes
- Identify gaps between business expectations and system limitations and suggest configuration improvements or streamlined maintenance processes and techniques
- Responsible for completing Peer Quality review of configuration updates
- Coordinate with the Neighborhood Application Support ticket tracking and bringing to resolution any software, configuration, EDI, CES tickets that require updates to the test or production environments
- Perform business analysis duties for designated corporate projects and maintenance requests
- Oversee process development and documentation for any new or altered functionality or business process. This will also include facilitating an annual audit of actual business processes versus what is documented
- Identify potential areas of automation and aid in re-engineering the underlying business processes
- Recommend and maintain standards for development of business cases and their documentation
- Coordinate multiple simultaneous projects and initiatives, while maintaining business as usual tasks.
- Other duties as assigned
- Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood's Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents
- Communicate Effectively
- Respect Others & Value Diversity
- Analyze Issues & Solve Problems
- Drive for Customer Success
- Manage Performance, Productivity & Results
- Develop Flexibility & Achieve Change
- Collaborate & Foster Teamwork
- Attend to Detail & Improve Quality
- Create & Innovate
- Plan & Organize
- N/A (e.g., Some travel locally between locations is required.)
- Bachelor's degree or a minimum of Five (5) years of experience and background equating to the degree in a health care setting
- Minimum of Five (5) years of business analysis and system configuration experience (or comparable skill set) working in a health care setting
- Demonstrated working knowledge of health care operations including but not limited to authorizations, benefits, enrollment, provider contracting, fiscal operations and claims adjudication
- Demonstrated working knowledge of system development life cycle processes
- Experience in identifying solutions to resolve design issues and to effectively communicate these solutions to the project manager/supervisor as well as stakeholders
- Experience in translating the results of design sessions into configuration requirements
- Experience in user acceptance testing based on business and configuration requirements
- Exceptional ability to identify and track issues and drive them to a conclusion
- Demonstrated ability in leading process improvement initiatives
- Experience producing project artifacts to include status reports, business requirements, non-technical design documents, etc.
- Excellent interpersonal skills, including the ability to work across the organization and to interact, influence and negotiate effectively at all levels of management
- Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment with accurate resource and time estimates
- Confident team builder and leader with strong motivational skills. Adept in problem solving and resolving conflict
- Proficient in Microsoft Office Suite - Word, Excel, PowerPoint, Visio, Outlook, SharePoint
- Bachelor's Degree in Health Care or Technology
- Experience with Optum CES claim editing software
- Experience with the Health Rules Payor Transactional System
- Working knowledge of State and Federal insurance programs
- Working knowledge of standard billing practices
- Working knowledge of CMS mandates and guidelines
- Certified Professional Coder
-
Configuration Analyst Iii
1 week ago
NTT DATA Woonsocket, United StatesConfiguration Analyst, NextGen System · Contract or Temp to Direct Hire · US Authorized only apply, W2 · Remote, US · Position Summary: · This is a fantastic opportunity for a senior level configuration / business analyst with more than six years of experience to transition from ...
-
Configuration Analyst
3 weeks ago
Neighborhood Health Plan of RI Smithfield, United StatesJob Details · Job Location Smithfield, RI - Smithfield, RI Position Type Full Time Education Level Associates Degree Travel Percentage Occasional Job Shift Daytime Job Category Professional / Experienced Description · Position Overview (On-site, Smithfield, RI) · The Configurat ...
-
Configuration Analyst
3 weeks ago
Neighborhood Health Plan of RI Smithfield, United StatesJob Details · Job Location · Smithfield, RI - Smithfield, RI · Position Type · Full Time · Education Level · Associates Degree · Travel Percentage · Occasional · Job Shift · Daytime · Job Category · Professional / Experienced · Description · Position Overview · (On ...
-
Configuration Analyst
3 weeks ago
Neighborhood Health Plan of RI Smithfield, United StatesJob Details · Job Location · Smithfield, RI - Smithfield, RI · Position Type · Full Time · Education Level · Associates Degree · Travel Percentage · Occasional · Job Shift · Daytime · Job Category · Professional / Experienced · Description · (In Office) · This posi ...
-
Configuration Management Analyst
5 days ago
Raytheon Marlborough, United States**Date Posted**: · **Country**: · United States of America · **Location**: · MA803: Marlborough, MA Building Boston Post Road Building 3, Marlborough, MA, 01752 USA · **Position Role Type**: · Hybrid · Are you ready to be part of a team whose influence spans the globe and extends ...
-
Configuration Management Analyst
1 week ago
Raytheon Marlborough, United States**Date Posted**: · **Country**: · United States of America · **Location**: · MA803: Marlborough, MA Building Boston Post Road Building 3, Marlborough, MA, 01752 USA · **Position Role Type**: · Remote · Are you ready to be part of a team whose influence spans the globe and extends ...
-
Senior Configuration Analyst
3 weeks ago
Neighborhood Health Plan of RI Smithfield, United StatesJob Details · Job Location · Smithfield, RI - Smithfield, RI · Position Type · Full Time · Travel Percentage · Occasional · Job Shift · Daytime · Job Category · Professional / Experienced · Description · Position Overview: · (On-site, Smithfield, RI) · The Senior Co ...
-
Senior Configuration Analyst
3 weeks ago
Neighborhood Health Plan of RI Smithfield, United StatesJob Details · Job Location · Smithfield, RI - Smithfield, RI · Position Type · Full Time · Travel Percentage · Occasional · Job Shift · Daytime · Job Category · Professional / Experienced · Description · In Office Position (Smithfield, RI) · Position Overview: · Thi ...
-
Configuration Analyst
2 weeks ago
Gardner Resources Consulting, LLC Providence, United StatesOur client, a health insurance provider, is looking for configuration analyst to join their team. · Duties and Responsibilities · The duties for this position include, but are not limited to the following items: · Serve as a resource in facilitating the gathering of business req ...
-
Configuration Analyst
3 weeks ago
Hub Technology Group Providence, United States· Junior to Mid- level Configuration Analyst. · Contract to Perm Hybrid · Responsible for the analysis, design, testing and implementation of configuration changes to front end systems. The role requires strong analytical and problem solving skills, the ability to work indep ...
-
DentaQuest Wellesley Hills, United StatesYou are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspir ...
-
Configuration Management Analyst
1 week ago
Stellent IT LLC Franklin, United StatesTitle: Configuration Management Analyst · Location: Franklin, MA · Interview Mode: Phone + Skype · Duration: 6+ month · Key notes · Our client has two (2) immediate needs for a Configuration Management Analyst or CM Analyst. · Critical qualifications include a technical degre ...
-
Configuration Management Analyst
1 week ago
Advantage Technical Franklin, United StatesThis position is responsible for maintaining and managing technical data for product configurations. The candidate will coordinate CCB meetings, prepare or review engineering changes and variances, and investigate their effect on overall product baselines. The CM analyst will mai ...
-
Configuration Managment Analyst
4 days ago
The Davis Companies Wrentham, United StatesContract assignment for a CM Analyst position in MA · 2 openings onsite -hybrid possible · Bachelor's degree in a Technical Field · 5+ years of CM related experience in a manufacturing environment. · Hands on experience with a PDM tool, Windchill/PDMLink a plus. · Ability to rea ...
-
Sr. HRP Configuration Analyst
20 hours ago
Gardner Resources Consulting, LLC Rhode Island, United StatesUnderstanding of healthcare benefits and how they impact claims adjudication. · Benefit and Claims configuration experience (benefits, supplier contracts, claims processing rules). · Front End configuration experience within HealthRules Payor Manager and Designer applications. · ...
-
MES Camstar Configuration Analyst
3 weeks ago
Kelly Science Engineering Technology & Telecom Bridgewater, United StatesKelly Technology is looking for a · MES Configuration Analyst - Direct · Hire · Hybrid in Bridgewater, NJ. This position is · open with our client, one of the leading medical devices companies, operating globally. · Title: · MES Configuration Analyst - Camstar · Location: Br ...
-
Configuration Analyst I/II
1 week ago
Northrop Grumman Plymouth, United StatesAt Northrop Grumman, our employees have incredible opportunities to work on revolutionary systems that impact people's lives around the world today, and for generations to come. Our pioneering and inventive spirit has enabled us to be at the forefront of many technological advanc ...
-
MES Camstar Configuration Analyst
3 weeks ago
Kelly Science, Engineering, Technology & Telecom Bridgewater, United StatesKelly Technology is looking for a · MES Configuration Analyst - Direct · Hire · - Hybrid in Bridgewater, NJ. This position is · open with our client, one of the leading medical devices companies, operating globally. · Title: · MES Configuration Analyst - Camstar · Location: ...
-
Data and Systems Integration Analyst
1 week ago
North Providence School Department North Providence, United States**Position Summary**: · The Data and Systems Integration Analyst serves in a crucial role with ensuring the smooth operation and efficiency of District data initiatives while contributing to data-driven decision making, improved student outcomes, and providing accurate and timely ...
-
Hmis Data Analyst
5 days ago
Rhode Island Coalition to End Homelessness Providence, United States**Responsibilities and Accountabilities**: · Under the direction of the HMIS Data Coordinator, the HMIS Data Analyst is responsible for leading all system wide data analysis activities as well as working with the HMIS team to ensure the System Administration, Data Quality and Rep ...
Senior Configuration Analyst - Smithfield, United States - Neighborhood Health Plan of RI
Description
Job Details
Job Location Smithfield, RI - Smithfield, RI Position Type Full Time Travel Percentage Occasional Job Shift Daytime Job Category Professional / ExperiencedDescription
Position Overview: (On-site, Smithfield, RI)
The Senior Configuration Management Analyst is senior level position responsible for the analysis, design, build, testing, implementation, and maintenance of system configuration to support business requirements and optimize system functionality. This position is responsible for identifying areas of automation and enhancement to support and improve internal workflows, review system capabilities, and identify gaps and limitations. In addition, this role is responsible for ensuring adherence to the system development lifecycle and maintenance of all supporting documentation. The role requires strong analytical and problem-solving skills, the ability to work independently and proactively as well as demonstrated skills in providing excellent customer service. Extensive knowledge of all aspects of heath care operations workflow and terminology is also required.
Duties and Responsibilities
The duties for this position include, but are not limited to the following items:
Core Company-Wide Competencies:
Job Specific Competencies:
FDR Oversight: N/A
Travel Expectations:
Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
Qualifications
Qualifications Required:
Qualifications Preferred:
Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.