Lead Systems Configuration Technical Analyst

Job Summary

The Lead Systems Configuration Technical Analyst is responsible for managing complex system configurations, health plan implementations and conversions within the Core Configuration team. Primary responsibilities include the accurate interpretation of specific state/federal and/or business requirements and the impact to the various system modules to convert them into configuration parameters within the core system(s). 

The Lead will support integration and business process activities that utilize configuration as part of the end-to-end solution to meet business requirements. This position will identify opportunities for improvement, as well as be able to suggest ways to bridge the gap between inter-dependent departments.  

The Lead will triage possible issues identified and implement applicable remediation to address confirmed configuration issues. This position will redesign complex business concepts resulting to correct processing conflicts. The position will work with and mentor people of various professional, vocational, and educational backgrounds.  This position will be responsible for the daily workflow and leading the work of assigned staff.  This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.

Duties

Implementing complex system configuration changes to the managed care core system. Evaluating, testing, and validating configuration changes ensuring they meet service levels and quality standards.  Ensuring completeness of requirements for the design and implementation of system business solutions.  Triaging system issues and implementing applicable remediation to resolve issues.

Developing solutions to resolve problems and making recommendations for improvements to process, configuration and products.  Developing complex business requirement specifications to complete configuration analysis and design. Analyzing user requirements, evaluating functionality and configuration options available to improve business results.  

Mentoring and training team members, providing guidance and solutions to system users and technical resources. Providing technical advice on business impact and opportunities. Creating and developing training documentation and presentations.

Attending and collaborating cross-functional meetings to develop, document and present system solutions.   Lead the translation of business requirements into configuration requirements. Lead the formulation and definition of system scope and objective based on users’ needs and understanding of business processes.   Participating in solution design by preparing and evaluating alternative solutions. Developing and presenting proposals for modifications.

Managing complex projects, engaging and updating key stakeholders, developing timelines, leads others to complete deliverables on time and ensures implementation upon approval.

Lead the work of assigned staff; regularly assigns and checks the work of others, providing guidance, training and feedback on performance to department management.  Overseeing the daily office workflow, develops and recommends enhancements to process and procedures. 

Perform other duties as assigned.

Duties Continued

Education Required

Education Preferred

Experience

Required:

At least 5 years of experience in benefit, contract configuration and product interpretations in a healthcare/ health plan environment with 5 years of claims experience and 3 years in medical coding initiatives and guidelines.

Minimum of 3 years of lead experience (process, program, or staff).

Skills

Required:
Expert level of knowledge of QNXT.

Requires excellent analytical, organization and communication skills.

Requires in-depth knowledge of system analysis and configuration.

Able to breakdown raw information and undefined problems into specific, workable components that in-turn clearly identifies the issues at hand.

Ability to understand a customer's business needs and translate needs into specific requirements.

Ability to plan and account for configuration impacts across business processes and applications.

Demonstrated ability to collaborate with other members of formal and informal groups in the pursuit of common missions, vision, values and mutual goals.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Additional Information