Responsible for overseeing the maintenance of the QNXT business application systems. This includes performing complete and thorough analysis of business application system configuration and/or operational procedures to find optimal solutions for change. Implements efficiencies and configuration changes that will optimize business system configurations. Supports QNXT and other business application system implementations and maintenance activities, including configuration and documentation of all system files and options. Responsible for overseeing and executing detailed test plans to ensure smooth production implementation. Reviews test results with the Systems Configuration Analyst and Business Analysts to ensure implementation of changes meet project expectations
Primary Duties, Responsibilities and Competencies:
Lead Duties & Responsibilities
- Works with Systems Configuration Analyst to define and prioritize projects.
- Maintains QNXT configuration (reference files, configuration module settings, etc)
- Analyzes business requirements and objectives towards determining the optimal configuration of those requirements.
- Creates complex design documents through the assessment of requirements. Assesses alternatives to different designs and chooses best solution to fit business needs.
- Performs complex work flow analysis and recommend alternatives based on one or more configuration solutions.
- Keeps abreast of new version changes and the impact on configuration and maintain updates with Systems Configuration Analyst.
- Performs detail unit testing on complex configuration changes.
- Prioritizes and coordinates multiple tasks simultaneously, and meets deadlines
- Performs complex data modeling and analysis with minimal oversight.
- Adheres to departmental and corporate policies and procedures.
- Attends improvement training programs when available and offered.
- Applies practical thinking and decision making
- Supports team decisions, collaborates with others to develop team solutions, builds consensus, and promotes teamwork through building consensus to develop mutual trust, respect, and commonality of goals.
Required Education, Skills, Competencies, and Qualifications:
- Assists with interviewing potential new hires with the Sr. Director of Plan Operations.
- Tracks new hire training and re-training documentation for all department staff.
- Provides regular feedback to employee regarding progress performance determined by department needs and/or Sr. Director of Plan Operations’ direction.
- Provides additional training when needed; reports potential issues to Sr. Director of Plan Operations.
- Provides input to the Sr. Director of Plan Operations related to staff job performance.
- Monitors attendance and absences, including prescreening of all PTO requests and timesheets and forwards to Sr. Director of Plan Operations for sign-off.
- Maintains a calendar of approved PTO requests.
- Establishes atmosphere of compliance with requirements within the department:
- Becomes a subject matter expert (SME) of key requirements (contractual, regulatory, accreditation) related to departmental and pertinent interdepartmental activities with related reference materials supporting these activities.
- Ensures all department work flows are in place.
- Matches relevant P&P’s used to support workflows.
- Monitors departmental staff conformance to work flows and work flow effectiveness.
- Identifies interdepartmental and organizational interdependencies.
- Trains department staff on interdepartmental dependencies.
- Participates in organizational workgroups as assigned.
- Acts as point of escalation for non-standard departmental transactions and/or dissatisfied customers.
- Assists with re-assigning workloads during critical periods.
Preferred Education, Skills, Competencies, and Qualifications:
- Bachelor’s degree in business administration, information science, computer science, industrial engineering or a relevant area, or equivalent technical skills and experience
- Minimum 5 years of healthcare industry; experience within Medicare/Medicaid managed care, hospital, medical office or equivalent
- Possess problem solving and project management skills. Must be able to take charge, manage numerous projects and successfully coordinate projects with internal areas and external vendors.
- Project team member oversight management and/or supervisory experience required.
- Excellent analytical and organization skills. Detail oriented.
- Excellent communication and organization skills
- Excellent interpersonal skills, including the ability to work with all levels of personnel.
- 3-5 years of claims processing experience
- Experience with SQL/data extraction tools
- Familiarity with data structures and data types
An Equal Opportunity Employer
- 1-3 years of QNXT Professional Certification highly desirable or equivalent QNXT configuration experience
- Previous experience with documentation of systems configuration highly desirable
AlohaCare - 16 months ago