Were searching for a Configuration Analyst Lead someone whos ready to be part of the best ranked childrens hospital in Texas and among the best in the this position you will be responsible for the oversight of configuration activities related to system updates new health plan implementations and conversions within Business Operations. Designs configurations solutions to meet new business requirements and perform updates for benefits coding contracts fee schedules and Optum PPS Rate Manager in adherence with business policies and Texas Medicaid requirements. Will work closely with Leadership to ensure the team meets both quality and SLAs and to identify and lead training needs.
Think youve got what it takes
Job Duties & Responsibilities
Monitors configuration intake tickets and assigns work to the Configuration Team.
Manage assignment of Configuration work including generating daily inventory reports and assignment of tickets to the Business Ops configuration staff.
Respond to inquiries the analyst may have regarding the configuration requests in a timely manner identify patterns and gaps to assist with training.
Partners with Configuration Manager on more complete issues that may require a business decision change including data and analytics to support decision making process.
Partner with the Configuration Manager to assess training needs and identify analysts that need additional support and collaborate on developing training plans including delivery of specific training where applicable.
Ensure that both the intake inquiries through all channels and TCHPs ticketing system are assigned timely and all configuration work through all intake channels (TFS CRMs etc.) is accounted assigned and completed as per required SLAs.
Partner with Configuration Manager to report any issues around remaining timely with all configurations and within the departments SLA and KPI metrics.
Generate reports including claims impact reports as needed.
Partner with the Quality Audit team for targeted audits responsible for first level review of audit results. Report results to leadership with preliminary findings and business acumen.
Complete monthly reviews of peer review results and report results to leadership with findings and remediation plans.
Delivers training to the Configuration team.
Assist Leadership with complex issue research and perform system audits as needed.
Configuration Lead for all system upgrades.
Oversees Configuration Changes to Production.
Skills & Requirements
H.S. Diploma or GED required
Bachelors degree preferred
A bachelors degree may substitute for the two (2) years of required work experience.
BET - Benefit Engine for Tapestry preferred
6 years Managed care claims processing and/or configuration of benefits/contracts/fee schedules/medical policy payment rules required
Required Experience:
IC
Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades suc ... View more