Configuration Analyst, Senior

Job DescriptionJob Description

The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

What You Will Be Doing:

This position is responsible for managing major system configurations, health plan implementations and conversions within the System Configuration team. The primary responsibilities include the accurate interpretation of specific state and/or federal guidelines that impact benefits, contracts, codification, and business requirements and converting them into configuration parameters within the core systems. Other responsibilities are coding, updating and maintenance benefit plans, provider set-up (demographic and contracts affiliations), fee schedules and various system tables through the user interface.

The Senior Configuration Analyst elicits complex business requirements through group meetings, interviews, observation, and/or existing systems, and business or policy documentation. This role independently mentors and contributes to the Configuration Analysts team with complex and comprehensive documentation of the technical requirements or systems modifications in a format that facilitates a business and technical communication and understanding amongst the business department or individuals. The Senior Configuration Analyst must have the ability to independently analyze or mine data, draw sound conclusions, and is able to interpret and follow detailed and precise written and oral instructions such as checklists, process diagrams, and policy. The Senior Configuration Analyst will lead communications and facilitation efforts to present the documented findings and results from an analytical engagement. The position will be required to work with and mentor people of various professional, vocational, and educational backgrounds.

Remote. Must reside in California

Our Vision:

Continuously improve the health of our community.

Our Mission:

We provide healthcare value and advance wellness through community partnerships.

Essential Functions:

• Independently works with Executives, Management, Staff, or Business analysts to identify, document, and redesign complex business concepts or processing conflicts.
• Lead and mentor in technical areas and independently provide knowledge and documentation exchange to educate team members in Analytical roles in support of team redundancy.
• Master and provide formal user education with software productivity and technical tools such as Microsoft Office, Visio, Team Foundation Server, or Attachmate to document business and technical process requirements related to a technology system.
• Ability to independently create technical processing macros using programming logic and native functions to perform repetitive or analytical tasks within productivity software such as Microsoft Office and Attachmate.
• Comprehend, analyze, and document business or process requirements using personal interviews, document analysis, meetings, surveys, process documents, or actual scenarios.
• Take on duties of a Project Manager for medium to large sized projects using standard PMBOK processes to identify scope, requirements, resources, and stakeholders using standard analysis techniques.
• Analyze and document functional business environments that facilitate work throughout the company.
• Develop complex business requirement specifications through internal and external research to complete technical analysis, and articulate and formally present research to various skill levels.
• Lead business meetings leveraging the Agile process to assist business units in the “What” session to ensure the creation and documentation of stories and acceptance criteria.
• Lead Configuration and Project teams in the Agile “How” session to understand technical requirements related to the business stories and acceptance criteria.
• Effectively communicate and collaborate with internal and external customers in support of analytics or problem resolution.
• Successfully engage in multiple complex initiatives simultaneously
• Recommend reconciliation points necessary after a comprehensive process or data analytics engagement to mitigate/resolve present and future reconciliation conflicts.
• Possess excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts.
• Limited skills in capacity of the various department technological resources and their roles in order to provide detailed analytics in everyday communications.
• Master of the American National Standards Institute (ANSI) formats that govern healthcare Electronic Data Interchange (EDI).
• Expert ability in the structure query language (SQL) for analytical data mining, software development, TFS, and business reporting.
• Comprehend and implement system configuration changes of the managed care core system software to process data transactions for business functions such as eligibility, claims, authorizations, and case management.
• Mentors and leads in the creations of testing plans that are used in the testing and implementation of software systems used by the organization.
• Comprehensive understanding in medical terminology to include ICD, CPT, and HCPCS coding systems.
• Oversee, identify, and create process checklists, for self and other analysts, which will be used to process HPSJ Health Systems (HPSJ) programs and applications to support departmental activities.

What You Bring:

Knowledge, Skills, Abilities and Competencies

Required

• Extensive knowledge of all core QNXT system modules
• Ability to configure and update all standard core QNXT system modules
• Extensive knowledge of core QNXT system databases
• Ability to independently perform complex system and data analytics
• Extensive knowledge of other systems such as OPTUM PPS, CES,

and NetworX Pricer and Modeler
• Extensive knowledge of other systems such as JIVA or other Medical Management Platforms

• Ability to independently create intermediate SQL queries
• Ability to independently leverage advanced SQL functions such as temp tables, multiple joins, inner/outer joins, and advanced analytics.
• Ability to independently create pivot tables from SQL output
• Ability to independently leverage all data sets and DBs
• Ability to independently create scripts to update data
• Extensive knowledge of core system databases and the ability to assist other technical staff with navigating system data, including the data structures for reporting.
• Ability to independently comprehend technical infrastructure including systems, DB, integration points, and reporting for coordination of efforts on systems managed by config team
• Ability to provide recommendations for process improvement, automation, and

enhancements
• Ability to effectively communicate with technical and non-technical disciplines
• Ability to independently lead in cross functional business and technical meetings
• Ability to independently perform Scrum Master duties
• Ability to maintain effective working relationships with all teams
• Ability to independently perform Scrum Master duties
• Ability to lead small (3-6 months) department projects
• Extensive experience and knowledge of the Agile Methodology

What You Have:

Education and Experience

Education:

Bachelor’s degree in Computer Science, Mathematics from an accredited institution or related field and six (6) years progressive experience in a Configuration Analyst capacity or similar Analytical position for a medium to large organization with a structured IT department in healthcare.

OR

Experience:

Healthcare experience: 10+ years.

Claims Operations or application vendor experience: 5 + years.

Benefit and Contract Configuration experience: 3+ years

Experience interpreting benefits, contracts and other business requirements: 5+ years

Experience in medical coding initiatives and coding guidelines: 3 + years

Experience in Medical Management system configuration. 3+ years

Experience in Medical Management system configuration. 3+ years

Expert level of knowledge in QNXT and/or JIVA

The incumbent must have basic technical skills that come from a Degree in Information Systems or 6-8 years of general analytical experience.

License:

None required

What You Will Get:

HPSJ Perks:

• Competitive salary
• Robust and affordable health/dental/vision with choices in providers
• Generous paid time off (starting at 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)
• CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution plan
• Two flexible spending accounts (FSAs)
• Employer-Paid Term Life and AD&D Insurance
• Employer-Paid Disability Insurance
• Employer-Paid Life Assistance Program
• Health Advocacy
• Supplemental medical, legal, identity theft protection
• Access to exclusive discount mall
• Education and training reimbursement in addition to employer-paid elective learning courses.
• A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.
• A shorter commute ­– if you’re commuting from the Central Valley to the Bay Area.
• Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.

We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.

HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics.

Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.

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