Senior Configuration Management Analyst

About the role

The Senior Configuration Management Analyst is a 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, reviewing system capabilities, and identifying gaps and limitations. In addition, this role ensures 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, and demonstrated skills in providing excellent customer service. Extensive knowledge of all aspects of healthcare operations workflow and terminology is also required.

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.
• Identify areas of unused/underutilized system functionality to support business initiatives.
• Perform post-implementation audits to ensure configuration aligns with current business requirements and processes.
• Facilitate and lead meetings and selected workgroups as required.
• Mentor and train Configuration Analysts on configuration best practices.
• Assist management with onboarding new hires, acting as an onboarding buddy, and leading training sessions.
• Assist management with oversight of augmented staff by tracking performance and escalating issues.
• Serve as a key resource in facilitating the gathering of business and technical requirements, including test cases for all configuration changes.
• Work with corporate project stakeholders and Business Analysts to formulate and communicate business requirements and project scope.
• Translate business requirements into technical specifications and act as a liaison to translate technical questions and processes into formats 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 creating and configuring benefit plans using best practices.
• 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 to maintain the integrity of the environment.
• Conduct 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 outcomes, partnering with Business Analysts and Testing teams 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 necessary remediation.
• Coordinate and document all configuration activity for change control and auditing.
• Coordinate production turnover of all configuration work upon business owner sign-off and perform post-production validation.
• Responsible for the Configuration Management Promotion process for HealthRules, Optum CES, Burgess Source, and other systems as needed.
• Serve as a subject matter expert for root cause analysis and issue resolution, providing guidance on system limitations and functionality.
• Develop proof of concept prototype configurations to support business requirements and create documented solutions and processes.
• Identify gaps between business expectations and system limitations and suggest configuration improvements or streamlined maintenance processes and techniques.
• Complete Peer Quality reviews of configuration updates.
• Coordinate with Neighborhood Application Support ticket tracking and bring to resolution any software, configuration, EDI, or CES tickets requiring updates to 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, including facilitating an annual audit of actual business processes versus documented processes.
• Identify potential areas of automation and aid in re-engineering underlying business processes.
• Recommend and maintain standards for the development of business cases and their documentation.
• Coordinate multiple simultaneous projects and initiatives while maintaining business-as-usual tasks.

Qualifications

Required

• Bachelor’s degree or a minimum of nine (9) years of relevant work experience and background equating to the degree in a healthcare setting.
• Minimum of five (5) years of business analysis and system configuration experience (or comparable skill set) working in a healthcare setting.
• Demonstrated working knowledge of healthcare operations including authorizations, benefits, enrollment, provider contracting, fiscal operations, and claims adjudication.
• Demonstrated working knowledge of system development lifecycle processes.
• Experience in identifying solutions to resolve design issues and effectively communicating these solutions to project managers, supervisors, and stakeholders.
• Experience translating the results of design sessions into configuration requirements.
• Experience in user acceptance testing based on business and configuration requirements.
• Exceptional ability to identify and track issues and drive them to conclusion.
• Demonstrated ability in leading process improvement initiatives.
• Experience producing project artifacts including status reports, business requirements, and non-technical design documents.
• Excellent interpersonal skills, including the ability to work across the organization and interact, influence, and negotiate effectively at all levels of management.
• Demonstrated ability to manage multiple priorities simultaneously in a deadline-driven environment with accurate resource and time estimates.
• Confident team builder and leader with strong motivational skills, adept in problem-solving and resolving conflict.
• Proficient in Microsoft Office Suite – Word, Excel, PowerPoint, Visio, Outlook, SharePoint.

Preferred

• Bachelor’s Degree in Health Care or Technology.
• Experience with Optum CES claim editing software.
• Experience with the HealthRules Payor Transactional System.
• Working knowledge of State and Federal insurance programs.
• Working knowledge of standard billing practices.
• Working knowledge of CMS mandates and guidelines.
• Certified Professional Coder certification.
• Experience with JIRA.
• Experience with SQL queries.
• Experience with Burgess Source.