- Be responsible for healthcare configuration solutions within PHP's core claims processing products (Facets, Networx, Optum Pricing, Optum CES).
- Understand how these products integrate with other PHP systems such as Care Advance, TCS, UPP, PIMS etc.
- Have broad understanding of health plan wide processes, including claims processing, medical/payment policies, product implementations, provider network development and contract management.
- Have ability to collaborate and communicate with our business partners is critical as we strive for alignment on intent, automation solutions and data accuracy.
- Do analysis and continuous optimization of system functionality with focus on root cause analysis to ensure we are implementing long term data fixes is also key.
- Work from high level functional analysis, detailed technical system configuration and support of business and management decisions.
- Ensuring all existing PHP provider and employer contracts and regulatory requirements are correctly and effectively administered.
- Ensuring new employer and provider contracts, benefits, and provider risk arrangements/financial incentives can be administered successfully prior to established deadlines.
- Maintaining a global understanding of the software functionality to accommodate the evolving Health Plans business needs.
- Prioritizing and managing the high volume of system configuration and maintenance tasks and understanding what constitutes a priority.
- Developing and administering effective audits to maintain system data integrity.
- Working with people who span a wide range of positions inside and outside the organization, sharing information with them as appropriate to facilitate work processes and management decision-making.
- Understanding and applying FACETS functionality to the ever-changing environment including consumer driven healthcare, and complex provider contracting requirements.
- Being able to present complex technical information and recommendations in a clear and concise manner and organize information to facilitate effective decision making.
- Maintains an in-depth working knowledge of FACETS and integrated applications: understand the relationship between and implications of changes across applications as well as impacts to downstream reporting and vendors.
- Perform system configuration analysis, design, coding and unit testing for simple to medium complex customer specific solutions within Facets and integrated with Facets such as CES, Networx (and other Pricing software), UPP, PIMS. Evaluates proposed policy changes and impacts. Ensures correct administration and adherence to policies, procedures and regulatory guidelines.
- Perform feasibility review within the assigned discipline, key participant in product portfolio development, implementation of mandates, network development, software upgrades and operational workflow discussions.
- Optimizing and/or implementing new operational processes for continued efficiency.
- Trouble shooting problems and utilize appropriate resources for research and correction.
- Follows guidelines for documentation and resolution of issues within our internal change management system to support SLAs. Departmental reporting to assist with workload and SLAs.
- Performs audits as needed to ensure effective administration of health plan contracts and processes. Participate in audits as directed.
- Assists in developing and writing technical procedural documentation within the scope of knowledge.
- Maintaining project plans as related to implementation tasks.
- In depth understanding of managed care transaction systems required.
- Understanding of strategic and tactical direction of Providence Health Plans.
- Ability to learn new software and concepts quickly.
- Proficient in Microsoft Office Suite to include Word, Excel, MS Access.
- Ability to create Facets MS Access database queries and/or SQL to support configuration analysis work. Comprehension of the Facets Data Dictionary and Data Model.
- Demonstrated excellent analytical, organizational and time management skills.
- Excellent interpersonal, persuasion and negotiation skills. Ability to work collaboratively with internal and external customers to help teams develop sound business decisions and requirements.
- Effective listening and critical thinking skills.
- Effective problem solving with attention to detail and high level of accuracy.
- Understand business rule logic for the functional area and high level business requirements for each product line, provider network etc.
- Knowledge of operational processes and core business functions within the Health Plan.
- Ability to help develop, interpret, and implement configuration for the assigned functional area (i.e.: Provider, Pricing and Benefits).
- Excellent written and verbal communication skills.
- Ability to manage multiple and constantly changing priorities.
- 3 years of medical claims or relevant health insurance operations experience
- Bachelor's Degree
- FACETS experience
-
IS System Configuration Analyst II
2 weeks ago
CareOregon Portland, United StatesCandidates hired for remote positions must reside in Oregon, Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. · Job Title · IS System Configuration Analyst II · Exemption Status · Exempt · Department · Operations · Manager Title · IS Development Manager · D ...
-
SAP TM Configuration Analyst
3 weeks ago
Mavensoft Technologies Hillsboro, United States**Role: SAP** **TM** **Configuration Analyst (SAP Transportation Management)** **Key Skills:** SAP TM Configuration, SAP Transportation Management experience, especially Freight Charge Calculation, setup of Freight Agreements, Calculation Sheets, and Rate Tables Must Have : SAP T ...
-
SAP MM With IS-Retail Analyst
2 weeks ago
TEKsystems Beaverton, United States ContractWe have an existing client looking to hire a SAP P2P/MM Analyst with IS-Retail / AFS experience to its ongoing S/4 Hana transformation project. This is a 100% remote project working PST hours. · As a SAP Material Master BSA, you will work with Purchasing, Sales and other functio ...
-
SAP BPA Consultant
19 hours ago
Cloudious LLC Beaverton, United StatesJob Description · Job DescriptionSAP BPA ConsultantHillsboro, OR(Onsite)Contract0Job Description/ Responsibilities · Design, develop, and implement SAP Business Process Automation (BPA) solutions to automate core business processes. · Analyze existing business processes, identify ...
-
Job Opening
19 hours ago
Lorven technologies Beaverton, United StatesJob Description · Job DescriptionHello, · We are urgently looking out for the Candidates for the below position. If you are interested in below role to apply, please give a quick response here · In case this job does not match your profile and you know somebody, who can fit into ...
-
Other Service Line
18 hours ago
Sedna Consulting Group Beaverton, United StatesJob Description · Job Description · Job Description: Location: ONSITE in Hillsboro, OR. Please include your candidate's location and availability with each submission. · Max Vendor Rate: Pending Confirmation from Cog (will update once rec.) · Industry: Retail · JOB TITLE: SAP BPA ...
-
Security Analyst I
2 days ago
Dat Services Inc Beaverton, United StatesAbout DAT · DATis an award-winning employer of choice and a next-generation SaaS technology company that has been at the leading edge of innovation in transportation supply chain logistics for 45 years. We continue to transform the industry year over year, by deploying a suite of ...
-
IT Technical Analyst
1 week ago
Ledgent Technology Portland, United StatesRole: IT Technical Analyst · Location: Wilsonville, OR - hybrid following training · Position Type: Full-time, Direct Hire · Annual Salary: Pending additional details on compensation · POSITION SUMMARY: · The IT Technical Analyst supports company computer systems, working closely ...
-
Human Resources Business Systems Analyst
3 weeks ago
Clackamas County Oregon City, United StatesJOB DETAILS AND QUALIFICATIONS · INFORMATION SESSION: · Would you like to learn more about this opportunity, working on the Workforce Data Management Team, our commitment to customer service, and being part of the Department of Human Resources at Clackamas County? Please conside ...
-
Workday Finance Implementation Lead
4 weeks ago
Kinder Care Portland, United States Full timeFutures start here. Where first steps, new friendships, and confident learners are born. At KinderCare Learning Companies, the first and only early childhood education provider recognized with the Gallup Exceptional Workplace Award , we offer a variety of early education and chi ...
-
Global Workday Specialist
6 days ago
Media Portland, United StatesAbout the Role · We are seeking a Workday HRIS Analyst to join our team and take our HR systems and processes to the next level. As the Global Workday Specialist, you grow the role for configuring changes in Workday aligned with business requirements, managing advanced reportin ...
-
Sr. Data Ops Engineer
2 weeks ago
Concora Credit Beaverton, United StatesOverview: · We hire people, not positions. That's because, at Concora Credit, we put people first, including our customers, partners, and Team Members. · Concora Credit is guided by a single purpose: to help non-prime customers · do more · with credit. · Today, we have helped ...
-
Dimensional Evaluator
3 weeks ago
Precision Castparts Corp. Portland, United States Full timeCountry United States of America State / County Oregon City Portland Division Structurals Company LPC Function Operations Workplace Type On-Site Position type Full Time Opportunity ID 12484 · Company Profile With more than 120 operations and approximately 20,000 employe ...
-
Sheriff's Office Fleet Coordinator
2 weeks ago
Clackamas County Oregon City, United StatesJOB DETAILS AND QUALIFICATIONS · The Clackamas County Sheriff's Office is seeking an experienced, detail oriented individual to fill the position of Sheriff's Office Fleet Coordinator (classified as a Management Analyst 1). The purpose of this position is to plan, coordinate, a ...
-
Dat Services Inc Beaverton, United StatesAbout DAT · DATis an award-winning employer of choice and a next-generation SaaS technology company that has been at the leading edge of innovation in transportation supply chain logistics for 45 years. We continue to transform the industry year over year, by deploying a suite of ...
-
SAP Intelligent RPA – Manager
1 day ago
Cognizant Beaverton, United States Full timeAbout Cognizant's SAP Practice · Cognizant's SAP practice is part of our Enterprise Platform Services (EPS) unit. In Cognizant's SAP practice, we help enterprises maximize business value in the digital economy. As part of this practice, you will drive digital acceleration, to pre ...
-
Financial Systems Analyst
3 weeks ago
Fortive Beaverton, United States Full timeWe are a global industrial technology innovator with a startup spirit. Our forward-looking companies pioneer the way in software-powered workflow solutions, data-driven intelligence, AI-powered automation, and other innovative technologies We're a force for progress, working alon ...
-
Network Analyst
1 week ago
University of Oregon Portland, United StatesReporting to the Director of Network Operations , the Network Analyst will configure, test, and install network equipment including wireless access points, layer 2 network switches, optical transceivers, and routing hardware. In addition, this positi Network Analyst, Network, Net ...
-
Workday Analyst
3 weeks ago
LHH Recruitment Solutions Portland, United StatesJob Description · Job DescriptionJob Title: Direct Hire Workday Analyst · LHH Recruitment Solutions is thrilled to collaborate with a dynamic company in the Portland, Oregon area for a Direct Hire Workday Analyst position. Our partner boasts an employee-centric work culture and h ...
-
Epic Beaker Analyst- Remote
3 weeks ago
Bluebird Staffing Portland, United StatesEpic Beaker Analysts needed for Remote Permanent position · Must be willing to come onsite for big meetings, go lives, etc. if needed. · Salary range - $80,000 to $90,000 · Position Summary · The Epic Beaker Application Analyst supports the Beaker module by configuring and su ...
Facets Configuration Analyst - Beaverton, United States - Providence Health & Service
Description
Description
NOTE this is NOT an IT role and it will be configuring our Facets claims payment operating platform**
Providence is seeking a Facets Configuration Analyst, who will:
Major Challenges Include:
In this position you will:
Job Specific Knowledge, Skills and Abilities:
Required qualification:
Preferred qualifications:
Ourbest-in-class benefitsare uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering ourMissionof caring for everyone, especially the most vulnerable in our communities.
About the department you will serve.
Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
About Providence
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence has been serving the Pacific Northwest since 1856 when Mother Joseph of the Sacred Heart and four other Sisters of Providence arrived in Vancouver, Washington Territory. As the largest healthcare system and largest private employer in Oregon, Providence is located in areas ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland.
Our award-winning and comprehensive medical centers are known for outstanding programs in cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network also provides a full spectrum of care with leading-edge diagnostics and treatment, outpatient health centers, physician groups and clinics, numerous outreach programs, and hospice and home care.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
Requsition ID:
Company: Providence Jobs
Job Category: IT Administration
Job Function: Information Technology
Job Schedule: Full time
Job Shift: Day
Career Track: Business Professional
Department: 5018 OPS SYSTEM ADMINISTRATION OR REGION
Address: OR Beaverton 3601 SW Murray Blvd
Work Location: Murray Business Ctr Beaverton-Beaverton
Pay Range: $ $46.10
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.