Configuration Analyst

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The pay range for this position is listed below. Actual pay rate dependent upon experience.

Position Highlights

Looking for Candidate with Medical Coding background.

You Belong at Avera

Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

• System Configuration & Optimization: Build test implement and maintain Epic Tapestry components and functional workflows. Converting benefit plan requirements into system configurations collaborating with other analysts and business leaders ensuring data accuracy customizing settings to support payer-provider relationships and supporting the systems ongoing performance. Develop and improve workflows and business processes to improve customer service decrease operational administrative costs and improve overall health plan outcomes and quality. Collaborate with Epic and internal teams to implement and test new features and enhancements on a quarterly basis.
• System Support & Troubleshooting: Provide support for Epic Tapestry-related issues including performing root-cause analysis resolution documentation of results and present business impact analysis for proposed configuration changes. Monitor existing system performance and make configuration recommendations where appropriate to maintain acceptable levels of automation in claims adjudication and member enrollment workflows and accurate claims payment.
• Stakeholder Collaboration: Partner with internal teams including health plan business and functional operations teams Avera system stakeholders for other Epic applications and IT staff to ensure accurate and compliant system configurations. Work closely with operational teams to interpret functional operating procedures and align system capabilities with operational goals. Provide input on system design to improve efficiency and reduce administrative burden. Collaborate with data integration and reporting teams to ensure data consistency and performance.
• Requirement Analysis: Uses experience and judgement to plan and accomplish goals; performs a variety of complicated tasks to ensure that the core claims system is configured correctly by reviewing the system components and validating that the configuration aligns to legal plan documents and regulatory requirements. Interpret and analyze plan documents such as Evidence of Coverage (EOCs) fee or rate schedules policies code set changes and translate into technical specifications for the system.
• Data management: Provides analysis and documentation that supports configuration management design requirements traceability and audit controls needed to meet state and federal regulatory requirements. Work with Epic Chronicles and data models and understand relevant EDI (Electronic Data Interchange) formats like 834 837 and 835.

• Bachelors Bachelors degree in Healthcare Administration Information Systems or related field or Epic Tapestry Certification with 3 years of experience.
• Epic Certification - Epic Epic Tapestry certification or required to participate in Epic coursework and pass certification exams within 90 days of hire. within 90 Days
• Demonstrated critical thinking skills through evaluation analysis and creative solutions.
• Ability to think broadly identifying and understanding implications to the entire organization including excellent communication documentation and problem-solving skills.
• Ability to work independently and as part of a cross-functional team.

• 4-6 years Experience with complex system design preferred experience with claims adjudication platforms or ecosystems specifically Epic Tapestry.
• Background and knowledge of Health Plan operations and understanding of health plan processes systems and regulations including claims processing benefit configuration enrollment and provider networks. Including familiarity with CMS regulations HIPAA and payer-provider contracting.
• Proficiency in Microsoft Office Suite (Word Excel PowerPoint Outlook).
• Experience with Epic Chronicles and data models Care Management or other related modules.
• Familiarity with EDI (Electronic Data Interchange) formats (e.g.) and integration best practices.
• Professional and/or facility coding familiarity.

• Commitment to the daily application of Averas mission vision core values and social principles to serve patients their families and our community.
• Promote Averas values of compassion hospitality and stewardship.
• Uphold Averas standards of Communication Attitude Responsiveness and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles laws regulations and standards associated with but not limited to CMS The Joint Commission DHHS and OSHA if applicable.

Benefits You Need & Then Some

Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO available day 1 for eligible hires.

• Up to 5% employer matching contribution for retirement

• Career development guided by hands-on training and mentorship

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race color religion sex national origin disability Veteran Status or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application please call 1- or send an email to .