• Configuration Analyst

    Job Locations US-CA-Fairfield
    Job ID
    2019-1472
    Category
    Configuration
  • Overview

    The Configuration Analyst provides both operational support to, and analysis of, all Configuration-related activities. The Configuration Analyst creates, updates, tests and maintains system configuration to support all benefit designs and ensure successful configuration, integration, and accurate and timely payment of claims and all PHC systems. Coordinates testing, quality assurance, configuration, installation, and support to ensure smooth, stable and timely implementation of technology solutions, considering all the areas that a change may impact in the current benefit setup and determine the most appropriate way to implement the change (e.g., research and look at tables impacted, order of processing, down-stream impacts, and unintended consequences).

    Responsibilities

    • Gather, analyze, prepare and summarize PHC program and user needs, documenting requirements, and revising existing system logic difficulties as necessary. Create complex specifications for systems to meet requirements. Validate requirements against needs. Apply business systems concepts to design details of complex automated systems.
    • Apply technical expertise and business analysis concepts to identify, evaluate and define complex systems scope and objectives through research and fact-finding combined with an understanding of applicable business and industry requirements.
    • Participate in cross-functional teams to solve complex business or systems issues.
    • Participate in the Medi-Cal OIL review process. Verify that OILs and Medi-Cal Provider Manual updates correspond to PHC system configuration and report updates to impacted departments.
    • Provide input in evaluating how to best set up PHC benefits and systems (e.g. different tables,   different benefit setup approaches.
    • Consult with appropriate internal departments on issues of policy and program interpretation/clarity.
    • Develop, design and test PHC system Enhancement Work Plans for assigned projects.
    • Document PHC system configuration modifications and enhancements; maintain system configuration library and communicate changes to impacted PHC departments.
    • Maintain system tables for configuration, i.e., rates, procedure, diagnosis, cross-walk, etc.
    •  Analyze, research and resolve system errors generated during claims processing and design new configuration or modify existing configuration to ensure compliance with Medi-Cal and PHC program policies and procedures. Document modifications, instruct impacted departments on new process, and release changes for continued processing
    • Troubleshoot and perform research on medium to moderately complex claims processing issues and projects.
    • Provide user support and training on new applications upon request and approval of Director of Configuration.
    • Provide user support and training on new applications upon request and approval of Director of Configuration.
    • Develop and maintain internal processes related to automated workflow distribution systems for all impacted departments.
    • Attend off-site vendor conferences and trainings.

    SECONDARY DUTIES AND RESPONSIBILITIES

    • Performs other duties as assigned.
    • Provides backup support for Configuration Specialist functions.

     

    Qualifications

    Education and Experience

    Bachelor’s degree in related field preferred. Experience with AMISYS Advance or other claims payment system, fee schedules, and procedure/diagnosis code tables preferred. Minimum two (2) years’ experience analyzing and enhancing HMO or other automated claims examination systems; or equivalent combination of education and experience.

     

    Special Skills, Licenses and Certifications

    Knowledge of AMISYS Advance or similar claims payment system preferred. Understanding of claims processing requirements and ability to translate into systems change and reporting requirements preferred.

     

    Performance Based Competencies

     

    Excellent analytical skills to rationally resolve simple and/or complex policy and technical problems. Excellent written and oral communication skills. Ability to present statistical and technical data in a clear and understandable manner. Ability to articulate technical concepts with both technical and non-technical vendors, peers, and trainers. Excellent organization skills to work on multiple assignments simultaneously, prioritize work, and complete projects within established time frames.

     

    Work Environment And Physical Demands

    Ability to use a computer keyboard. More than 80% of work time is spent in front of a computer monitor. When required, ability to move, carry, or lift objects of varying sizes, weighing up to 10 lbs.

     

     

     

    All HealthPlan employees are expected to:

     

    • Provide the highest possible level of service to clients;
    • Promote teamwork and cooperative effort among employees;
    • Maintain safe practices; and
    • Abide by the HealthPlan's policies and procedures as they may from time to time be updated.

     

    IMPORTANT DISCLAIMER NOTICE

     

    The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform. The Employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed