Posted in Other 30+ days ago.
Type: Full Time
Description
TITLE: Configuration Analyst
DEPARTMENT: Configuration & Claims Operations
REPORTS TO: Configuration Manager
DATE: September 2019
* SUMMARY OF MAJOR RESPONSIBILITIES:
This position is responsible to design, configure, test, implement and maintain HealthRules Payor and Amisys pricing, claims and/or benefit configuration, according to business requirements, to support accurate and efficient claims processing and data reporting for UCare. Investigate and resolve configuration-related provider, member and claim processing issues and assist other departments in understanding HealthRules Payor and Amisys configuration.
II. SPECIFIC DUTIES AND RESPONSIBILITIES:
Please place an asterisk (*) in the first position of each duty/responsibility that is an essential function of the position.
* *Develop and maintain an understanding of current UCare HealthRules Payor and Amisys configuration, contracts, products and policies.
* *Analyze, configure, test, implement and maintain HealthRules Payor and Amisys to support changes in contracts, products, legislation, and UCare policies and procedures, ensuring timely maintenance and updates of configuration.
* *Assist in the development of test scenarios for changes and/or projects. Manage the timely resolution of open testing bugs and issues. Develop and monitor post production audit reports to ensure the intent of change and/or project requirements is being met.
* *Develop and maintain configuration documentation and communicate changes, as appropriate.
* *Collabroate with Technical Business Analyst, UAT and QA to create detailed functional requirements that support and align to business requirements and testing scenarios.
* *Research and respond to service requests in a prompt and timely manner and update or build configuration in HealthRules Payor and Amisys, as needed.
* *Recommend and assist with drafting new and updated procedures to maximize the use of HealthRules Payor, Amisys and other third party products to improve efficiency.
* *Develop and maintain good working relationships with the staff of other departments including Provider Relations & Contracting, Healthcare Economics, Provider Assistance Center, Government Relations, Product, and Coverage Policy.
* Inform leader and peers of changes that will impact UCare. Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner.
* Other projects and duties as assigned.
III. QUALIFICATIONS:
* Education
Bachelor's degree in business or health care preferred; demonstrated work experience may be considered in lieu of degree.
* Required Experience
Two years of configuration experience or a combination of claims processing, healthcare system operations, data analytics and configuration. Microsoft Office proficiency.
* Preferred Experience
Experience using Business Objects. Ability to build and maintain relationships across the enterprise. Strong knowledge of government programs, regulations and benefits. Previous experience with CMS, Client or payer reimbursement methodologies and /or payment policies. Knowledge of or experience with Optum Claims Editing System (CES) and Axiom TranSend.
D.KNOWLEDGE, SKILLS, AND ABILITIES
* Attention to detail and excellent analytical and problem solving skills.
* Excellent interpersonal communication skills, technical and non-technical.
* Ability to meet stringent deadlines.
* Excellent organizational skills and ability to set and manage priorities and handle multiple projects concurrently.
* Advanced verbal and written communication skills. Ability to communicate with technical and non-technical staff. Ability to communicate with staff at all levels of the organization.
* Ability to work independently and as part of a team.
* Demonstrated ability to perform analysis and identify solutions to resolve specific business issues.
* Customer Service: Adherence to UCare Values, Ethics and Confidentiality Standards and Policies.
NTT DATA, Inc. (the Company ) is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.
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