The role of this position is to formulate and define system configuration scopes and objectives through research and fact-finding based on user needs and system parameters. Frequently interact with department end users, providing core system functionality to end users on business requirements and needs. As a senior analyst, this person will also have the ability to lead a project as well as coordinate work efforts with other project team members.
Successful candidates will have experience in supporting the infrastructure of a transactional base system, which includes but not limited to member and provider data, benefit codes set, fee schedules maintenance and utilization / case management correlating authorizations to claims. Other requirements include translating business specifications into detailed technical specifications from which programmers will code. Analyze the capabilities of the application and the development tools available to determine the system / technical approach, investigating alternative approaches in cases where the application and development tools do not support the business requirement.
Ideal candidates will have 4 or more years experience working with a major managed care application. 2 years of experience specifically with TriZetto’s Facets application is preferred. Candidates must be familiar with CASE tools and the system development life cycle. Claims and/or utilization management experience is desired.
- Document system limitations to address business and operational requirements.
- Document reporting requirements and limitations to address business and operational requirements.
- Facilitate or lead project teams.
- Act as an IS Liaisonto the business areas, working closely with end users to answer questions regarding system functionality, triage requests for configuration or functional changes to the application, and help the business areas identify appropriate processes and procedures for effectively using the CORE Systems Application with the business community to develop standard policies and procedures for application change requests.
- Update and change system tables and other configurable elements of the application.
- Develop Business Specifications based on Change Requests generated by the user community to enhance the functionality of the Facets system.
- Translate Business Specifications into detailed Technical Specificationsfrom which programmers will code. Analyze the capabilities of the application and the development tools available to determine the technical approach, investigating alternative approaches in cases where the application and development tools do not support the business requirement.
- Devise or modify procedures to solve complex problems considering computer equipment capacity and limitations, operating time and form of desired results.
- Prepare detailed specifications from which programs will be written.
- Analyze and revise existing system logic difficulties and documentation as necessary.
- Perform quality assurance review and testing ofcompleted code and configuration changes to ensure that the business and technical specifications have been met, and that they do not produce any undesirable outcomes. Obtain business users’ acceptance and sign-off where appropriate.
- Assure Application Security by determining user access requirements, and assigning and limiting user access.
- Develop and conduct basic training needs with respect to CORE Systems Applications’ functional and navigational overview.
- Other projects and duties as assigned.
- Assess user needs and translate those needs into business and technical specifications.
- Effectively utilize computer and appropriate software and interact as needed with CalOptima Information Systems.
Experience & Education
- A relevant Bachelor’s degree or equivalent work experience.
- 4 or more years of experience working with a major managed care application.
- 2 years of experience specifically with TriZetto’s Facets application preferred.
- Microsoft tools.
- The System Development Life Cycle.
- Software applicable to assignment and CalOptima Information Systems.
CalOptima - 21 months ago