HealthRules Configuration Analyst

Tegria • New York, NY

1d

About The Position

Position Overview: The Senior Configuration Management Analyst is senior level position responsible for the analysis, design, build, testing, implementation, and maintenance of system configuration to support business requirements and optimize system functionality. This position is responsible for identifying areas of automation and enhancement to support and improve internal workflows, review system capabilities, and identify gaps and limitations. In addition, this role is responsible for ensuring adherence to the system development lifecycle and maintenance of all supporting documentation. The role requires strong analytical and problem-solving skills, the ability to work independently and proactively as well as demonstrated skills in providing excellent customer service. Extensive knowledge of all aspects of heath care operations workflow and terminology is also required. Duties and Responsibilities The duties for this position include, but are not limited to the following items: · Collaborate with business areas to understand financial impact to the organization for approved Medical Cost Action projects · Triage, research, and resolve escalated issues within industry standard timeframes to meet service level agreements · Responsible for identifying areas of unused/underutilized system functionality to support business initiatives · Perform post-implementation audits to ensure configuration aligns with current business requirements and process · As required, facilitate and lead meetings and selected workgroups · Mentor and train Configuration Analysts on configuration best practices · Assist management in in onboarding new hires, acting as onboarding buddy, and leading training sessions · Assist management with oversight of augmented staff by tracking performance, escalating issues, etcServe as a key resource in facilitating the gathering of business and technical requirements in addition to test cases for all configuration changes · Work with corporate project stakeholders and Business Analyst to formulate and communicate business requirements and scope of project · Work with various business areas at different levels within the organization to translate business requirements into technical specifications documents and also act as liaison to translate technical questions and processes into a format the business can understand · Analyze business requirements and objectives and perform system configuration analysis, design, coding, and unit testing following established processes, standards and procedures · Develop and maintain a library of standard operational procedures for all configuration tasks, including but not limited to creating and configuring benefit plans using best practice · Execute the build and implementation of benefit plan adjudication rules · Perform all configuration changes within multiple test environments, coordinating with testing and project teams to establish timelines and project planning in an effort to maintain the integrity of the environment in use · Responsible for configuration in depth research, review, and creation of claims data to validate configuration output is performing as expected · Handle the change control process when configuration results do not match expected outcome, partners with Business Analyst and Testing team to find solutions as needed · Develop and execute multiple unit test cases and complete Configuration Control Framework documentation to support configuration audit requests · Act as a liaison between business stakeholders and technical teams to validate and translate unit, positive, negative and regression testing results and any remediation necessary · Coordinate and document all configuration activity for change control and auditing · Responsible for coordination of production turnover of all configuration work upon business owner sign off as well as post-production validation · Responsible for the Configuration Management Promotion process for HealthRules, Optum CES, and Burgess Source and other systems as needed · Serve as subject matter expert for root cause analysis and issue resolution, by providing guidance on system limitations and functionality · Develop proof of concepts prototype configuration to support business requirements and develop documented solutions and processes · Identify gaps between business expectations and system limitations and suggest configuration improvements or streamlined maintenance processes and techniques · Responsible for completing Peer Quality review of configuration updates · Coordinate with the Application Support ticket tracking and bringing to resolution any software, configuration, EDI, CES tickets that require updates to the test or production environments · Perform business analysis duties for designated corporate projects and maintenance requests · Oversee process development and documentation for any new or altered functionality or business process. This will also include facilitating an annual audit of actual business processes versus what is documented · Identify potential areas of automation and aid in re-engineering the underlying business processes · Recommend and maintain standards for development of business cases and their documentation · Coordinate multiple simultaneous projects and initiatives, while maintaining business as usual tasks. Salary Range Now, a little about us … At Tegria, we bring bold ideas and breakthroughs to improve care, technology, revenue, and operations in ways that move healthcare organizations from patient-centered to human-centered. We are helping healthcare put people first—both patients and those who dedicate their lives to delivering care. And at the very core of this vital work is our incredibly talented people. People with different backgrounds who welcome challenge and change. People who listen first, ask hard questions, and make decisions to cultivate a culture of equity and inclusion. People who chase after goals, growth, and generosity. We’re real. We’re nimble, and we believe in our mission to humanize healthcare. Perks and benefits Top talent deserves top rewards. We’ve carefully curated a best-in-class benefits package, meant to meet you wherever you are in your life and career. Your health, holistically. We offer a choice of multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family. Your financial well-being. We offer competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and/or FSA), and more. And everything in between. Our lifestyle benefits are unrivaled, including professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way. Tegria is an equal employment opportunity employer and provides equal employment opportunities (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. All qualified candidates are encouraged to apply. Working at Tegria combines everything that's unique about our culture: our core values, our company meetings, our commitment to success, and our recognition programs, and most importantly, our people. Our employees are self-disciplined, hardworking, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make Tegria an outstanding place to work.

Requirements

• strong analytical and problem-solving skills
• the ability to work independently and proactively
• demonstrated skills in providing excellent customer service
• Extensive knowledge of all aspects of heath care operations workflow and terminology

Responsibilities

• Collaborate with business areas to understand financial impact to the organization for approved Medical Cost Action projects
• Triage, research, and resolve escalated issues within industry standard timeframes to meet service level agreements
• Responsible for identifying areas of unused/underutilized system functionality to support business initiatives
• Perform post-implementation audits to ensure configuration aligns with current business requirements and process
• As required, facilitate and lead meetings and selected workgroups
• Mentor and train Configuration Analysts on configuration best practices
• Assist management in in onboarding new hires, acting as onboarding buddy, and leading training sessions
• Assist management with oversight of augmented staff by tracking performance, escalating issues, etcServe as a key resource in facilitating the gathering of business and technical requirements in addition to test cases for all configuration changes
• Work with corporate project stakeholders and Business Analyst to formulate and communicate business requirements and scope of project
• Work with various business areas at different levels within the organization to translate business requirements into technical specifications documents and also act as liaison to translate technical questions and processes into a format the business can understand
• Analyze business requirements and objectives and perform system configuration analysis, design, coding, and unit testing following established processes, standards and procedures
• Develop and maintain a library of standard operational procedures for all configuration tasks, including but not limited to creating and configuring benefit plans using best practice
• Execute the build and implementation of benefit plan adjudication rules
• Perform all configuration changes within multiple test environments, coordinating with testing and project teams to establish timelines and project planning in an effort to maintain the integrity of the environment in use
• Responsible for configuration in depth research, review, and creation of claims data to validate configuration output is performing as expected
• Handle the change control process when configuration results do not match expected outcome, partners with Business Analyst and Testing team to find solutions as needed
• Develop and execute multiple unit test cases and complete Configuration Control Framework documentation to support configuration audit requests
• Act as a liaison between business stakeholders and technical teams to validate and translate unit, positive, negative and regression testing results and any remediation necessary
• Coordinate and document all configuration activity for change control and auditing
• Responsible for coordination of production turnover of all configuration work upon business owner sign off as well as post-production validation
• Responsible for the Configuration Management Promotion process for HealthRules, Optum CES, and Burgess Source and other systems as needed
• Serve as subject matter expert for root cause analysis and issue resolution, by providing guidance on system limitations and functionality
• Develop proof of concepts prototype configuration to support business requirements and develop documented solutions and processes
• Identify gaps between business expectations and system limitations and suggest configuration improvements or streamlined maintenance processes and techniques
• Responsible for completing Peer Quality review of configuration updates
• Coordinate with the Application Support ticket tracking and bringing to resolution any software, configuration, EDI, CES tickets that require updates to the test or production environments
• Perform business analysis duties for designated corporate projects and maintenance requests
• Oversee process development and documentation for any new or altered functionality or business process. This will also include facilitating an annual audit of actual business processes versus what is documented
• Identify potential areas of automation and aid in re-engineering the underlying business processes
• Recommend and maintain standards for development of business cases and their documentation
• Coordinate multiple simultaneous projects and initiatives, while maintaining business as usual tasks.

Benefits

• multiple health and dental plans with nationally recognized networks, as well as vision benefits, a total wellness program, and an employee assistance program for you and your family
• competitive wages, retirement savings plans, company-paid disability and life insurance, pre-tax savings opportunities (HSA and/or FSA)
• professional development offerings, opportunities for remote work, and our favorite: a generous paid-time-off program, giving you the flexibility to plan a vacation, take time away for illness (or life’s important events), and shift your schedule to accommodate those unexpected curve balls thrown your way

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed