Configuration Analyst II - 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 II is responsible for leading 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 configured information to insure that configuration outcomes meet the needs of the corporation. They will have overall responsibility for 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 II will be primarily responsible to provide technical and procedural guidance and oversight to the Configuration Analyst I to ensure the integrity and accuracy of the configuration of the CDPHP core claim system and integrated support systems. The Configuration Analyst II will represent various business units in the analysis, development and implementation of effective and efficient business applications. This role will lead the implementation strategy and define metrics to ensure the successful configuration of CDPHP's core claims systems and any integrated systems. The Configuration Analyst II will recommend system and configuration solutions and alternatives that meet business objectives, resolve system and configuration deficiencies and ensure efficient functionality. The Configuration Analyst II provides support and produces the deliverables associated with management, configuration and maintenance of the core system, and the integrated support systems.

QUALIFICATIONS:

• Minimum three (3) years' experience that 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 four (4) years of experience in healthcare programs, processes, and experience working with internal departments and external vendors is required.
• Three (3) years of business application management experience performing application design and development tasks is preferred.
• Experience in applying relational database concepts and techniques preferred.

• 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.
• Ability to successfully work with application management and development teams in defining system implementation, conversion, and configuration strategies is required.
• Demonstrated ability to lead project and configuration team initiatives to ensure completeness and accuracy is required.
• Ability to successfully mentor Configuration Analyst I team members as part of the career development program.
• Must be able to critically evaluate workflows and develop and implement process improvements.
• Must have an in depth understanding of the processes and rules, including benefits, pricing, enrollment, provider structure, payment and/or claims processing for each line of business.
• Must have a high 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.
• Proficiency in Microsoft Excel is required.
• Proficiency in Access and SQL is preferred.
• Proficiency in Configuration within the Facets Application is preferred.
• Excellent written and verbal communication skills as well as organizational skills are required.
• Bachelor's degree required. 7 years relevant experience may be substituted for degree.