Configuration Analyst I - 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.

The Configuration Analyst I is responsible for analysis, maintenance, and configuration of CDPHP's core claims systems and application systems, as well as modifying existing systems to improve workflows or to serve new purposes. They will be responsible for basic 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. The Configuration Analyst I will represent various business units in the analysis, development and implementation of effective and efficient business applications. This role will work directly with the Configuration Analyst II and Configuration Analyst III on implementation strategy and defining metrics to ensure the successful configuration of CDPHP's core claims systems and any integrated systems.

QUALIFICATIONS:

• Minimum two (2) years' experience that includes two or more of the following responsibilities is required; claims adjudication, progressive customer service, evaluation of business procedures and problems, healthcare benefit analysis, Facets system configuration, data collection/transformation/analysis, preparing detailed specifications for the development of business configuration and testing.
• A minimum of three (3) years' experience working with healthcare programs and processes amongst internal departments and/or external vendors is required.
• Experience in applying relational database concepts and techniques preferred.
• Associates degree required. 2 years relevant experience may be substituted for degree.
• Demonstrated ability to analyze, identify, implement and monitor outcomes required.
• Must be capable of participating in meetings with internal and external business stakeholders and demonstrate a clear understanding of that area's relationship with regard to the enterprise, operational structure, and application user interaction.
• Must be able to adapt to changing work priorities and a fast-paced environment while maintaining a professional attitude.
• Must have an understanding of the structure and impacts of member benefits, pricing, enrollment, provider structure, payment and/or claims processing, for each line of business.
• Must have a fundamental 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 work with an application management and development team in defining system implementation, conversion and configuration strategy is required.
• Proficiency in Microsoft Excel is required.
• Proficiency in Access and SQL experience preferred.
• Must be able to critically evaluate workflows and develop and implement process improvements.
• Excellent written and verbal communication skills as well as organizational skills are required.