Reports to: Martha Brooks
SCOPE OF POSITION:
Responsible for configuration and maintenance support of multiple assigned Corporate core systems e.g., Amisys, Vistar, Acuity. Manage integrity of configuration in interfacing subsystems. Responsibilities include maintaining system data integrity compliance with contractual arrangements with significant financial impact e.g., system configuration for the pricing of all provider claims. Assist in the coordination of medium sized projects.
ESSENTIAL JOB FUNCTIONS:
- Develop configuration methodology for assigned subsystems and maintain system global parameters and tables. Gather and document business requirements/processes and determine optimal configuration. Identify issues/and contract clarifications and ensure that resolutions are received from appropriate decision maker, generally Director level and above. Address requirements that cannot be configured in the system with end users and assist in the development of alternative solutions.
- Adhere to existing configuration audit and documentation procedures. Recommend improvements to existing procedures/coding standards.
- Responsible for the debugging and reporting of Corporate core system issues to the vendors. Communicate priorities to the vendors and assist the users in developing workaround solutions.
- Analyze any system errors from production processes. Address errors either in the configuration or by working with users to correct the data.
- Coordinate testing efforts with user departments and address any issues in configuration found. Obtain user department approvals prior to implementing configuration in production.
- Serve as the subject matter expert for functional and technical inquiries pertaining to Corporate core systems and other departmental support for assigned subsystems.
- Participate in cross functional task force to implement system updates and new releases that affect the assigned subsystems. Conduct system testing.
- Assist in the education of internal customers on the functions and capabilities of assigned subsystems. Develop and provide training sessions to internal customers.
- Serve as a backup for other assigned subsystems. Perform configuration audits.
- Cross train other configuration analyst(s) on assigned subsystems.
- Recognizes and observes all company and departmental policies and procedures.
- Focuses on achieving departmental and organizational objectives.
- Maintains professional appearance by complying with dress code in an appropriate manner
- Complies with company policies and procedures, which includes punctuality as they relate to work time, lunch, and break periods.
Bachelor’s degree in Health Sciences or similar concentration
Minimum 6 years experience in a complex managed care environment with multiple products and entities, with an emphasis in claims, pricing and/or benefits. Knowledge of coding structures (HCPCS, CPT4, Revenue codes etc) is preferred.
Solid understanding of system testing methodologies. Strong analytical, organizational skills and detailed oriented. Excellent verbal and written communication skills with solid documentation skills. Capable of conducting presentations and training sessions. Ability to manage processes and prioritize multiple tasks. Ability to work independently, as a member of a team or as a team lead. Conduct issue resolution involving multiple departments and demonstrate effective follow up skills.
AvMed Health Plans is a Drug/Tobacco Free Workplace EOE
AvMed Health Plans - 2 years ago