Configuration Analyst / Job Req 1040513923

Under general supervision by the Manager, Applications, the Configuration Analyst configures and maintains provider contracts, fee schedules and code sets in the HealthSUITE claims adjudication system. Additionally, this position provides technical and administrative support to operational areas to ensure that system configuration and data is precise and ready to support the operational and business needs of Alameda Alliance for Health (the “Alliance”) and its various business partners.

Principal responsibilities include:

• Configure provider contracts and fee schedules in the HealthSUITE claims adjudication system.
• Maintain and monitor updates of various code sets to ensure accurate and timely operations.
• Work with the business for the purpose of analysis and documentation of business needs and requirements.
• Analyze, design, test and develop system configuration needs to include documentation, adherence to change management standards and requirements, and preparation of work plans that deliver on schedule and within scope.
• Recommend efficient configuration in various systems to include, but not limited to, the main transaction system; medical management system; etc.
• Develop, implement, and maintain training solutions using a variety of methods, including one-on-one, web-based and classroom training.
• Customize out-of-the-box training content to better support key business processes as needed.
• Accountable for in-depth understanding of business/operational workflows and detailed understanding of new workflow objectives and knowledge of how the enterprise software application functionality will support new workflows.
• Responsible for assessing training needs of the organization’s staff to ensure successful incorporation of new workflows and policies and procedures into Enterprise software applications training programs.
• Provide expertise in healthcare industry best practices.
• Work as a team with departmental staff to identify opportunities for operational improvements.
• Continually review/audit system operations and operating results to ensure consistent application of policies, practices and optimal system configuration.
• Assist in preparing and maintaining up-to-date documentation of system operating policies and practices.
• Gather data for analysis to assist in system planning and upgrades.
• Maintain and monitor updates of various code sets and contracts to ensure accurate and timely operations.
• Ability to extract and synthesize data; and conduct and interpret quantitative and qualitative analyses.
• Complete special projects and other duties as assigned., * Maintain provider contracts, fee schedules and code sets.
• Assist with system upgrades and configurations.
• Keep abreast of healthcare industry best practices, system capabilities and managed care regulatory requirements.
• Consult with business areas to document business requirements, as is stages and workflows.
• Systematic analysis, problem solving, and design of workflows, configuration documents, test scenarios and project status reports.
• Data analysis and system audits to support operational efficiencies.
• Coordinate and manage training associated with system changes.
• Use outstanding customer service principals when servicing the needs of the business users.
• Comply with the organization’s Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls

PHYSICAL REQUIREMENTS

• Constant and close visual work at desk or computer.
• Constant sitting and working at desk.
• Constant data entry using keyboard and/or mouse.
• Frequent use of telephone headset.
• Constant verbal and written communication with staff and other business associates by telephone, correspondence, or in person.
• Frequent lifting of folders and other objects weighing between 0 and 30 lbs.
• Frequent walking and standing

EDUCATION OR TRAINING EQUIVALENT TO:

Bachelor’s Degree or equivalent work experience.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

• Minimum five years working as a business analyst working within the health care/managed care environment, preferably in business operations (e.g., claims) or in IT, or system configuration required., * Systems experience with HealthSuite and/or equivalent managed care transition systems required.
• Strong interpersonal skills with ability to function in a self-directed work team
• Ability to work effectively in a multidisciplinary team, providing leadership, guidance, information and stellar customer service.
• Experience gathering and documenting requirements.
• Experience developing test cases.
• Ability to extract and synthesize data and conduct and interpret quantitative and qualitative analysis.
• Experience with project management principles.
• Ability to plan and execute projects independently.
• Ability to communicate effectively, both verbally and in writing.
• Excellent organizational skills and orientation to detail.
• Intermediate level in Microsoft Visio, Access, Excel, Outlook, and PowerPoint or equivalent database and reporting.