Sr. Systems Configuration Analyst

Job Number: 6981

Workplace Type: Fully Remote

Position Title: Systems Configuration Analyst

External Description:

Overview of the Role:

The Sr. Systems Configuration Analyst will play a crucial role in managing and optimizing the configuration of claims systems and applications. The Sr. Systems Configuration Analyst’s primary responsibility is to ensure claims systems and applications are accurately configured. This role will serve as one of the primary supports in analyzing, implementing and maintaining configuration settings to ensure compliance with company policies, contracts and industry standards. Serves as a subject matter expert for configuration and related best practices.

Responsibilities:

• Serves as a subject matter expert for configuration change management testing and related best practices
• Analyze and interpret documents related to claim system configuration, including provider contracts, division of financial responsibility (DOFR), and health plan benefits, to ensure accurate system configuration.
• Conduct regular audits and validation of system configuration to ensure accuracy, compliance with regulations, company policies and contracts. Identify and address discrepancies or issues promptly.
• Trouble shoot and resolves configuration-related issues, working closely with internal teams and external vendors as needed.
• Collaborates with cross-functional teams to identify configuration needs and implement effective solutions.
• Collaborates with internal and external auditors to support the audit process related to configuration, including the preparation, organization, and submission of necessary documentation.
• Maintains thorough and concise documentation for tracking of all configuration changes and system testing.
• Recommend process improvements to enhance the efficiency and effectiveness of system configuration.
• Assists in the development and training of process documentations and workflows.

Requirements:

• Minimum of 5 years of experience in claims system configuration with strong understanding of healthcare data system
• Bachelor’s degree in Health Informatics or related field
• Demonstrated experience in managing complex system configurations, performing system audits and resolving configuration-related issues
• Strong analytical and problem-solving skills, with the ability to interpret complex healthcare documents and translating them to system requirements
• Excellent communication and interpersonal skills, with the ability to collaborate effectively with cross-functional teams
• Detail-oriented with exceptional organization skills and the ability to manage multiple tasks and projects simultaneously
• Working knowledge of healthcare coding systems such as ICD, CPT, HCPCS, revenue codes and other related codes.
• Familiarity with data analysis tools and SQL, a plus

Preferred Qualifications:

• Experience with medical claims systems such as Facets, pricing tools such as Optum PPS, and clinical claims editing softwares.
• In-depth knowledge of healthcare regulatory requirements including medical coding and Medicare pricers

Pay Range: $75,000 - $95,000 annually.

City: Remote - CA

State: California

Location City: Remote - CA

Location State: California

Community / Marketing Title: Sr. Systems Configuration Analyst

Company Profile:

Alignment Health is revolutionizing health care for seniors by leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].