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Description
Job Description
Job Title:
Facets Configuration Analyst with Pricing and NetworX exp a must.
Job ID:
11156
Location: Virginia Beach, VA
Full/Part Time:
Full-Time
Regular/Temporary:
Regular
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Responsibilities
JOB SUMMARY:
This is a senior technical position. Performs complex configuration activities. The incumbent for this position possesses a high degree of expertise in the configuration of business rules that support reimbursement policies and methodologies in a large managed care organization. This position plays a key role in the configuration and implementation of new markets and products.
PRIMARY RESPONSIBILITIES:
1. Works with Lead Configuration Analysts to define and prioritize projects.
2. Considers interdepartmental impact when recommending solutions and identifies opportunities for interdepartmental utilization of recommended solutions.
3. Works with peers in department to develop realistic project scope estimates, detailed project plans, and timelines.
4. Analyzes business requirements and objectives towards determining the optimal configuration of the requirements.
5. Configures, tests and documents configuration solutions for the following functions:
Provider reimbursement configuration set-up and maintenance
Benefit package configuration setup and maintenance
Membership/divisions configuration set-up and maintenance
Group/member premium configuration set-up and maintenance
Medical management configuration set-up and maintenance
Employer and state group/billing configuration setup and maintenance
Setup and maintenance of financial management risk pools in relation to healthcare software
Setup of code sets used for configuration in benefits and pricing and other sub-systems
6. Exercises good judgment in the use of configuration standards. Can propose business beneficial changes to coding standards and development procedures.
7. Adheres to existing configuration management procedures. Recommends improvements to existing procedures. Assesses work of team members to ensure compliance with procedures.
8. Creates complex design documents through the assessment of requirements. Assesses alternatives to different designs and chooses best solution to fit business needs.
9. Performs complex data modeling and database design with minimal oversight.
10. Adheres to departmental and corporate policies and procedures.
11. Attends improvement training programs when available and offered.
12. Other duties as assigned.
EDUCATION AND EXPERIENCE:
Education
Required:
Bachelor's degree in business administration, information science, computer science, industrial engineering or a relevant area, or equivalent technical skills and experience.
Years and Type of Experience Required:
Required:
A minimum of five years of configuration experience providing pricing and/or benefits configuration support on Amisys, Facets, MHS, Metavance, Diamond, or a similar payer system, preferably in a medium to large health care or related organization.
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.
Preferred:
Experience using a software development life-cycle methodology like the Software Development Life Cycle (SDLC).
Broad operational managed care background.
Specific Technical Skills
Required:
A minimum of two years of experience:
Using MS Office.
Using the Windows operating system and its utilities.
Using the internet to conduct research and to download information.
Using a relational database management system or SQL to retrieve and analyze data.
Familiarity with data structures and data types.
Preferred:
Formal coursework using a 3-GL or a 4-GL programming language (e.g., C+, Visual Basic).
Other
Required:
Ability to work with integrated data using a relational database management system or SQL.
Excellent analytical and organization skills.
Excellent verbal and written communication skills.
Excellent interpersonal skills, including the ability to work with all levels of personnel.
SCOPE INFORMATION
Item Measure
# Direct Reports None
# Indirect Reports Configuration Analysts I and II as needed
Budgetary $ Responsibility None
KPI Department Standards Yes - as determined
PHYSICAL REQUIREMENTS
Must be able to participate in meetings.
Must be able to operate a PC for extended periods of time.
Must be able to operate and effectively utilize office telephone equipment.
Equal Employment Opportunity
In accordance with state and federal laws, employment offers are tendered solely on the basis of qualifications without regard to race, religion, color, national origin, age, sex, marital status, sexual orientation, handicap (including disabled veterans) or Vietnam Era veteran status.
AMERIGROUP administers pre-employment drug testing as a condition of employment and a satisfactory criminal history background report.
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Details:
Job Id:
757975A0
Posted / Updated:
4/12/2010 3:52:59 AM
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