Configuration Analyst III - Pricing

Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.

Configuration Analyst III is responsible for oversight of the Configuration team's delivery of the analysis, maintenance, and configuration of CDPHP's core claims systems and applications application systems, as well as modifying existing systems to improve workflows or to serve new purposes. This position will be responsible for analysis, documentation, unit testing, and verification of all complex products, agreements and CDPHP strategic initiatives to ensure that configuration outcomes meet the needs of the corporation. They will have overall responsibility for complex and strategic functional design requirements, configuration, integration testing, design decisions, and issues resolution. This role will evaluate business procedures and problems, participate in business requirements gathering sessions, document functional specifications and solutions, build configuration, and prepare test plans/scripts for application and configuration testing for each line of business. Lines of business include; Commercial, ASO (Self-Funded, Administrative Services Only) and State and Government Programs. This role will oversee the implementation strategy for all new state and federal mandates to ensure the successful configuration of CDPHP's core claims systems and any integrated systems. The Configuration Analyst III will be responsible for the technical oversight of all departmental audit analysis as it relates to configuration of the Facets application including but not limited to; Federal, State, ASO, Internal and other audits as they relate to claims operations departmental processes. This role will be primarily responsible for the upkeep and maintenance of all configuration policies and procedures to ensure the accuracy of all configuration activities. The Configuration Analyst III will recommend system and configuration solutions and alternatives that meet business objectives, resolve system and configuration deficiencies and ensure efficient functionality. The Configuration Analyst III provides support and produces the deliverables associated with management, configuration and maintenance of the core system, and the integrated support systems.

QUALIFICATIONS:

• Minimum six (6) years of configuration and business analysis experience that includes: evaluation of business procedures and problems, feasibility studies, system configuration, configuration design, preparing detailed specifications for the development of business configuration, and testing is required.
• Bachelor's Degree or 4 years of equivalent experience required.
• A minimum of six (6) years of experience in healthcare programs, processes, and experience working with internal departments and external vendors is required.
• Six (6) years of business application management experience performing application design and development tasks is required.
• Minimum of six (6) years of experience in configuration within the Facets Application is required.
• Experience acting as a knowledge expert in cross-functional configuration lead for projects or company initiatives.
• Experience in applying relational database concepts and techniques required.
• Demonstrated ability to analyze, identify, implement, and monitor outcomes is required.
• Must be able to adapt to changing work priorities and a fast-paced environment while maintaining a professional attitude.
• Must have an in depth understanding of the processes and rules, including benefits, pricing, enrollment, billing, provider structure, payment and/or claims processing for each line of business.
• Must have an expert level of knowledge in healthcare in relation to supported lines of business that include; Commercial, ASO (Self-Funded, Administrative Services Only) and State and Government Programs.
• Ability to successfully lead application management and development teams in defining system implementation, conversion, and configuration strategies is required.
• Must be able to critically evaluate complex workflows and develop and implement process improvements.
• Proven ability to develop and document clear workflows and processes.
• Proficiency in Microsoft Excel is required.
• Proficiency in Access and SQL is required.
• High level of understanding of the Facets data model is required.
• Excellent written and verbal communication skills as well as organizational skills are required.