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Senior Configuration Analyst - Smithfield, United States - Neighborhood Health Plan of RI
Description
Job DetailsJob 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:
This position is senior level position responsible for the analysis, design, testing and implementation of configuration changes to support business requirements.
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.
Duties and Responsibilities
The duties for this position include, but are not limited to the following items:
Work with key project stakeholders to formulate, validate and communicate business requirements and scope of project
Work with business areas to understand impact to organization areas and systems
Responsible for research, design and application of configuration required to support business requirements
Perform all configuration changes within applicable software test environments
Develop and execute test cases and documentation to support configuration changes/updates/additions
Responsible for configuration, interface and application testing
Coordinating and documenting for all configuration activity for change control and auditing
Responsible for reviewing test results with business owners and obtaining sign off for production implementation
Responsible for coordination of production turnover of all configuration work upon user sign off
Develop and maintain standards for development of business processes and their documentation
Serve as a subject matter expert for root cause analysis and issue resolution
Serve as a resource to other areas in Business and Technical Services
Identify potential areas of automation and aid in re-engineering the underlying business processes to achieve process improvement
Responsible for identifying areas of unused/underutilized system functionality to support business initiatives
Perform post implementation audits to ensure configuration matches current business documentation and process
Coordinate multiple simultaneous projects and initiatives
As required, facilitates and leads meetings and selected workgroups
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
Qualifications
Qualifications 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
Qualifications Preferred:
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
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.
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