We are looking for a Sr. Benefit Configuration Analyst who is a SME in Benefit Configuration. The Sr. Benefit Configuration Analyst will play an essential role in our clients' projects by leading Facets configuration design, system changes, and quality assurance testing. The Sr. Benefit Configuration Analyst will work with the Project team to gather and document requirements; develop or modify data, information, and functions for the Health Plan processes; including, but not limited to, benefit configuration, claims processing, clinical editing, utilization management, and enrollment.

Skills

• Uses extensive Facets configuration, business knowledge, and effective communication skills to lead, facilitate, and elicit requirements for projects

• Assists with the analysis and documentation of current and future states, defining user requirements in the design of the future state workflows, to optimize system functionality

• Develops business process artifacts (configuration design documents, process flow, work state diagrams, etc.) as they pertain to enterprise-level processes, spanning multiple functional areas. Documents and implements configuration and process improvements and control documentation

• Reviews change requests to ensure consistency and compatibility to existing systems and procedures, including researching, validating, and resolving issues for accurate processing. Identifies, communicates, documents, and escalates information from all levels (end-users to leadership)

• Troubleshoots configuration and technical issues, and identifies modifications needed to meet changing user and regulatory requirements

• Assists in the education and training of end-users. Supports development of expert users, and mentors inexperienced users

• Manages and facilitates meetings and presentations effectively and professionally to report progress and any issues. Prioritizes, plans, and organizes with Project Manager to ensure high quality results are completed on time

Key Qualifications

• Experienced in eliciting requirements from business users to define and document project requirements, with the ability to perform business analysis and translate the outcome into definable software functionality

• Knowledge of computer software systems and applications and database set-up and management. Expert in the use of Word, Excel, Visio, and other tools used for documentation and reporting purposes including MS Excel, MS Access, Crystal Reports and Microsoft Project (or other related project management software)

• Meticulous attention to detail. Strong analytical, problem solving, negotiation, and collaboration skills, based upon goal and results orientation. Process driven, with proven ability to plan and execute multiple concurrent projects

• Superb written and verbal English language communication skills, as well as interpersonal skills; able to communicate and influence peers, directors, and executives; to set clear expectations and realistic goals. Expert in the presentation of configuration ideas, status, solutions, and results

• Superior task management skills, with the ability to work under pressure, independently, or as part of a team in situations in which multiple priorities are likely

• Experience required in all or most of the following; Medicaid, Medicare, ITS, FEP, knowledge of healthcare governmental strategy and business model, PPACA/HCR, Healthcare Exchange, EDI transactions, ICD-9 to ICD 10 conversion, Facets experience including technical knowledge of database supporting Facets

Perks

• Competitive pay and bonuses

• Excellent benefits (medical, dental, vision)

• 401K with percentage company match

• Paid holidays and vacation days

• Flexible schedule

Education and Experience

• Bachelor's degree in healthcare administration or related field. Applicable experience may be considered in lieu of a bachelor's degree

• Minimum 5 years of experience in multiple functional areas of health insurance and at least 10 years of working as a Facets Configuration Analyst including testing of new workflow processes, maintenance of system databases