Senior Configuration Analyst
Kern Family Healthcare. The friendly face
We are looking for fun, intelligent, team oriented people who believe in our core values: Trust, Respect and Integrity.
This position is responsible for managing major system configurations, health plan implementations and conversions within the System Configuration team. The primary responsibilities include the accurate interpretation of specific state and/or federal guidelines that impact benefits, contracts, codification, and business requirements and converting them into configuration parameters within the core systems. Other responsibilities are coding, updating and maintenance benefit plans, provider set-up (demographic and contracts affiliations), fee schedules and various system tables through the user interface.
- Independently works with Executives, Management, Staff, or Business analysts to identify, document, and redesign complex business concepts or processing conflicts
- Lead and mentor in technical areas and independently provide knowledge and documentation exchange to educate team members in Analytical roles in support of team redundancy.
- Master and provide formal user education with software productivity and technical tools such as Microsoft Office, Visio, Team Foundation Server, or Attachmate to document business and technical process requirements related to a technology system.
- Ability to independently create technical processing macros using programming logic and native functions to perform repetitive or analytical tasks within productivity software such as Microsoft Office and Attachmate.
- Comprehend, analyze, and document business or process requirements using personal interviews, document analysis, meetings, surveys, process documents, or actual scenarios.
- Take on duties of a Project Manager for medium to large sized projects using standard PMBOK processes to identify scope, requirements, resources, and stakeholders using standard analysis techniques.
- Develop complex business requirement specifications through internal and external research to complete technical analysis, and articulate and formally present research to various skill levels.
- Lead business meetings leveraging the Agile process to assist business units in the “What” session to ensure the creation and documentation of stories and acceptance criteria.
- Lead Configuration and Project teams in the Agile “How” session to understand technical requirements related to the business stories and acceptance criteria.
- Possess excellent verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts.
- Master of the American National Standards Institute (ANSI) formats that govern healthcare Electronic Data Interchange (EDI).
- Expert ability in the structure query language (SQL) for analytical data mining, software development, TFS, and business reporting.
- Comprehend and implement system configuration changes of the managed care core system software to process data transactions for business functions such as eligibility, claims, authorizations, and case management.
- Mentors and leads in the creations of testing plans that are used in the testing and implementation of software systems used by the organization.
- Comprehensive understanding in medical terminology to include ICD, CPT, and HCPCS coding systems.
Bachelor’s degree in Computer Science, Mathematics from an accredited institution or related field AND six (6) years progressive experience in a Configuration Analyst capacity or similar Analytical position for a medium to large organization with a structured IT department in healthcare.
Healthcare experience: 10+ years.
Claims Operations or application vendor experience: 5 + years.
Benefit and Contract Configuration experience: 3+ years
Experience interpreting benefits, contracts and other business requirements: 5+ years
Experience in medical coding initiatives and coding guidelines: 3 + years
Expert level of knowledge in QNXT
- Pay Type Salary
- Travel Required No
- Travel % 0
- Telecommute % 0
- Required Education Equivalent Experience
- Kern Family Health Care, Bakersfield, California, United States of America