Configuration Analyst

Job Number: 3902

Workplace Type: Fully Remote

Position Title: Configuration Analyst

External Description:

Position Summary:

The Provider Configuration Analyst is primarily responsible for ensuring benefits and payment terms are accurately configured within Alignment’s core systems. The successful candidate will analyze complex business requirements, translate them into system design parameters and update consuming systems appropriately – ensuring a high degree of quality and accuracy, while continuously identifying opportunities for process and technical improvements. The Analyst will also be responsible for supporting end-to-end system validation and testing activities, under the supervision of the Configuration Manager and Senior Leadership. This role requires comfort operating within a fast-paced, dynamic and often ambiguous environment.

General Duties/Responsibilities (May include but are not limited to):

· Translates complex contract and benefit detail into system design and requirements

· Loads and maintains accurate benefit and payment terms within Alignment’s core operating systems

· Identifies and proposes process and technical improvements to internal leadership and technical partners

· Proactively identifies risks or potential downstream issues and surfaces them to the right functional partners and leaders

· Quantifies impacts of potential risks or issues and delivers clears, concise impact analyses and recommendations

· Collaborates with other Configuration team members, Utilization Management and Claims business units to assure configuration in each of their respective legacy functions are in sync, and operate in a flexible unified fashion

· Creates and implement updates to policies and procedures as necessary.

· Ensures operating metrics are documented and reported upon in a timely manner

· Addresses questions and issues in a timely and professional manner

· Generates ad hoc reports as needed for claims, financial or network impact analyses and review

· Ensures compliance-related reports, SOPs and requests for information are up-to-date and delivered in a timely and accurate manner.

· Tests, or supports testing of, system enhancements and changes, and ensures resources and tools are available to resolve defects

· Represents Configuration in workgroups and committees as necessary

· Performs other duties and special projects upon the request

Supervisory responsibilities:

N/A

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Minimum Experience:
5+ years’ experience in health care operations with comprehensive experience in Medicare Advantage, network management / contracting, provider operations, health plan systems and technology, claims processing and systems, and the deployment of managed care pricing initiatives & configuration
Background in codifying benefit plans and provider contracts in transactional systems.
Education/Licensure:
Bachelor’s degree preferred. Relevant experience in lieue of degree will be acceptable.
Other:
Knowledge and experience working with administration of Medicare Advantage plans and delegated environment
Excellent communication skills, both written and oral
Ability to lead discussions and problem resolution groups within the organization
Ability to effectively escalate or elevate issues in a positive, solution-oriented way
Strong Microsoft Office skills in Word, Excel and Powerpoint. Database experience a plus

Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.

2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

City: Remote - CA

State: California

Location City: Remote - CA

Location State: California

Community / Marketing Title: Configuration Analyst

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! 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, 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].