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Configuration Analyst Principal II - Credentialing Job
Date: Nov 21, 2009
Location: Virginia Beach, VA, US
Job Title:
Configuration Analyst Principal II - Credentialing
Job ID:
10352
Location: Virginia Beach, VA
Full/Part Time:
Full-Time
Regular/Temporary:
Regular
JOB SUMMARY:
This is a senior technical position which requires extensive knowledge in the configuration of Facets. The incumbent for this position possesses a high degree of expertise in the configuration of business rules and applications that support reimbursement policies and methodologies in a large managed care organization. This position plays a key role in the architecture and implementation of new market business, in market growth, issue resolution, and in the analysis and configuration of provider and state contracts and benefits. This position is responsible for the preparation of performance reports for the department. The incumbent is responsible for managing configuration projects, coaching and indirect management of other analysts.
PRIMARY RESPONSIBILITIES:
1. Works with operational areas in the definition of projects to enable prioritization for analysis and solution recommendation.
2. Considers interdepartmental impact when recommending solutions and identifies opportunities for interdepartmental utilization of recommended solutions.
3. Works with peers in Advanced Solutions and Project Management to develop realistic project scope estimates, detailed project plans, and timelines.
4. Demonstrates comprehensive working knowledge of managed care operational areas and managed care products in each market in which Amerigroup operates, including current trends in the industry.
5. Participates in the quality assurance of all Business Configuration projects.
6. Demonstrates a high understanding of software development lifecycle and development methods. Uses these to resolve very complex design issues. Uses SDLC development methods or industry best practices.
7. Performs complex data modeling and database design.
8. Analyzes business requirements and objectives towards determining the optimal configuration of the requirements.
9. Acts as the point person between Configuration and Advance Solutions to ensure that all application and technically-oriented issues relating to the configuration project are appropriately addressed.
10. Acts as business subject-matter expert to other implementation initiatives, including conversion, report and interface development.
11. Manages the maintenance and implementation pricing and benefits configuration.
12. Demonstrates a thorough understanding of data architecture.
13. Adheres to existing configuration management procedures. Recommends improvements to existing procedures. Assesses work of team members to ensure compliance with procedures.
14. Creates complex design documents through the assessment of requirements. Assesses alternatives to different designs and chooses best solution to fit business needs.
15. Exercises good judgment in the use of configuration standards. Can propose business beneficial changes to coding standards and development procedures.
16. Assist with providing gap analysis between business requirements and system functionality.
17. Provides technical support for new development projects and market expansions.
18. Manages large and complex configuration projects.
19. Reviews and guide analysis and configuration efforts of analysts.
20. Understands strategic alignment of business solutions with business objectives.
21. Mentors junior configuration analysts.
22. Adheres to departmental and corporate Policies and Procedures as outlined by Management.
23. Participates in relevant training programs when available and offered.
24. Develops and maintains departmental performance reports.
25. 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.
Preferred:
* Masters degree in business administration, information science, computer science, industrial engineering or a relevant area.
Years and Type of Experience Required:
Required:
* Fourteen or more 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:
* Proven ability to manage complex projects.
* Excellent analytical skills including being able to present data to senior management
* Excellent verbal and written communication skills
* Excellent interpersonal skills, including the ability to work with all levels of personnel including, but not limited to peers and Senior Management within the organization
* Knowledge of managed care including, but not limited to claims adjudication and payment, medical management, provider fee-for-service reimbursement, capitation, billing, enrollment, and benefits.
* Strong negotiation and facilitation skills.
* Excellent customer relation skills.
* Detail oriented.
* Assertiveness.
* Ability to deal with a fast paced environment and make proper decisions quickly.
* Appreciation of cultural diversity and sensitivity towards target population
SCOPE INFORMATION
Item Measure
· # Direct Reports N/A
· # Indirect Reports Yes - as determined
· 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.
Configuration Analyst Principal II - Credentialing
Job ID:
10352
Location: Virginia Beach, VA
Full/Part Time:
Full-Time
Regular/Temporary:
Regular
JOB SUMMARY:
This is a senior technical position which requires extensive knowledge in the configuration of Facets. The incumbent for this position possesses a high degree of expertise in the configuration of business rules and applications that support reimbursement policies and methodologies in a large managed care organization. This position plays a key role in the architecture and implementation of new market business, in market growth, issue resolution, and in the analysis and configuration of provider and state contracts and benefits. This position is responsible for the preparation of performance reports for the department. The incumbent is responsible for managing configuration projects, coaching and indirect management of other analysts.
PRIMARY RESPONSIBILITIES:
1. Works with operational areas in the definition of projects to enable prioritization for analysis and solution recommendation.
2. Considers interdepartmental impact when recommending solutions and identifies opportunities for interdepartmental utilization of recommended solutions.
3. Works with peers in Advanced Solutions and Project Management to develop realistic project scope estimates, detailed project plans, and timelines.
4. Demonstrates comprehensive working knowledge of managed care operational areas and managed care products in each market in which Amerigroup operates, including current trends in the industry.
5. Participates in the quality assurance of all Business Configuration projects.
6. Demonstrates a high understanding of software development lifecycle and development methods. Uses these to resolve very complex design issues. Uses SDLC development methods or industry best practices.
7. Performs complex data modeling and database design.
8. Analyzes business requirements and objectives towards determining the optimal configuration of the requirements.
9. Acts as the point person between Configuration and Advance Solutions to ensure that all application and technically-oriented issues relating to the configuration project are appropriately addressed.
10. Acts as business subject-matter expert to other implementation initiatives, including conversion, report and interface development.
11. Manages the maintenance and implementation pricing and benefits configuration.
12. Demonstrates a thorough understanding of data architecture.
13. Adheres to existing configuration management procedures. Recommends improvements to existing procedures. Assesses work of team members to ensure compliance with procedures.
14. Creates complex design documents through the assessment of requirements. Assesses alternatives to different designs and chooses best solution to fit business needs.
15. Exercises good judgment in the use of configuration standards. Can propose business beneficial changes to coding standards and development procedures.
16. Assist with providing gap analysis between business requirements and system functionality.
17. Provides technical support for new development projects and market expansions.
18. Manages large and complex configuration projects.
19. Reviews and guide analysis and configuration efforts of analysts.
20. Understands strategic alignment of business solutions with business objectives.
21. Mentors junior configuration analysts.
22. Adheres to departmental and corporate Policies and Procedures as outlined by Management.
23. Participates in relevant training programs when available and offered.
24. Develops and maintains departmental performance reports.
25. 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.
Preferred:
* Masters degree in business administration, information science, computer science, industrial engineering or a relevant area.
Years and Type of Experience Required:
Required:
* Fourteen or more 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:
* Proven ability to manage complex projects.
* Excellent analytical skills including being able to present data to senior management
* Excellent verbal and written communication skills
* Excellent interpersonal skills, including the ability to work with all levels of personnel including, but not limited to peers and Senior Management within the organization
* Knowledge of managed care including, but not limited to claims adjudication and payment, medical management, provider fee-for-service reimbursement, capitation, billing, enrollment, and benefits.
* Strong negotiation and facilitation skills.
* Excellent customer relation skills.
* Detail oriented.
* Assertiveness.
* Ability to deal with a fast paced environment and make proper decisions quickly.
* Appreciation of cultural diversity and sensitivity towards target population
SCOPE INFORMATION
Item Measure
· # Direct Reports N/A
· # Indirect Reports Yes - as determined
· 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.
Nearest Major Market: Virginia Beach
Apply now »
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