Configuration Management Analyst (44246)

Job DetailsJob Location: Smithfield, RI - Smithfield, RI 02917Position Type: Full TimeEducation Level: Associates DegreeTravel Percentage: OccasionalJob Shift: DaytimeJob Category: Professional / Experienced

The Configuration Management Analyst is an entry to mid- 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 also 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.

Duties and Responsibilities

The duties for this position include, but are not limited to the following items:

Serve 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 collaborators 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 Neighborhood 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

Other duties as assigned

Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood’s Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Qualifications

Qualifications

Required:

Associates degree and/or years of relevant work experience and background in lieu of a degree

Minimum of two (2) years of business analysis and benefits and claims system configuration experience; or similar demonstrated experience working with health care claim processing

Prior experience in a healthcare organization/setting

Excellent interpersonal skills, including the ability to work across the organization and to interact, influence and negotiate effectively

Ability to manage multiple priorities simultaneously in a deadline driven environment

Proficient in MS Project, Excel, PowerPoint and Word

Strong communication skills, both verbal and written

Preferred:

Experience with the Health Rules Payor transactional system

Experience with JIRA

Experience with Optum CES (Claims Editing Software)

Experience with SQL queries

Experience with Burgess Source

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.