Configuration Analyst II

Pay scale information is not necessarily reflective of actual compensation that may be earned nor a promise of any specific pay for any selected candidate or employee which is always dependent on actual experience education qualifications and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems Inc. is looking for extraordinary people to join our team!

Why join MedImpact Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity high performance and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products systems and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction service cost and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Summary

The Configuration Analyst II designs builds and maintains claims system configurations to ensure accurate compliant adjudication across healthcare programs such as FFS and MCO. This role translates complex business and regulatory requirements into system rulescovering benefits pricing and editswhile collaborating with stakeholders and technical teams to ensure solutions are implemented correctly and perform as intended. The analyst supports new implementations benefit updates and ongoing system maintenance by troubleshooting issues and optimizing performance while also promoting quality and operational excellence through adherence to governance standards thorough documentation and continuous process improvements.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Configure pharmacy formulary and benefit plan components within the claims adjudication system to accurately implement approved change requests.
• Manage assigned workload to ensure all configuration tasks and change requests are completed within established timelines and service level expectations.
• Develop deep expertise in claims system logic including adjudication processing system constraints benefit coding structures and plangroupcarrier relationships to ensure configuration designs meet intended business outcomes.
• Analyze troubleshoot and resolve basic to moderately complex claims processing issues and customer inquiries; escalate complex issues as needed while ensuring timely resolution and clear communication.
• Collaborate closely with clients business partners and internal stakeholders to gather clarify and translate business requirements into effective configuration solutions that are accurately documented developed tested and implemented.
• Apply standardized design methodologies and governance practices to ensure configuration solutions are efficient scalable and sustainable; provide clear justification and documentation for non-standard designs.
• Perform in-unit testing and validation to confirm configurations function as expected meet business requirements and support accurate claims adjudication.
• Execute end-to-end workflow activities including pre-assessment design configuration and unit testing across varying levels of complexity (Level 13 tasks).
• Leverage strong organizational prioritization and project coordination skills to manage multiple initiatives while maintaining high quality and accuracy.
• Support and mentor junior analysts (Level I) providing training guidance and assistance with more complex configuration scenarios.
• Create maintain and enhance detailed documentation of client plan designs including adjudication hierarchies edits restrictions tables carrier relationships and configuration best practices.
• Partner with Testing & Validation teams to ensure seamless transition of configurations into formal testing cycles and production readiness.
• Contribute to continuous improvement efforts by identifying opportunities to streamline configuration processes enhance quality and improve overall operational efficiency.

Supervisory Responsibilities

No supervisory responsibilities

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written). One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

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 accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BS/BA and 2 years experience or equivalent combination of education and experience

Computer Skills

Intermediate knowledge of MS Office / Word PowerPoint Outlook and MS Excel. The ability to run SQL queries and script load.

Certificates Licenses Registrations

Pharmacy Technician License or National Certification helpful.

Other Skills and Abilities

• Ability to gather business requirements and client specifications. Demonstrated ability to positively interact with clients internal customers and peers. Demonstrated willingness to take accountability for achieving service commitments and a demonstrated ability to achieve results.

• Demonstrates ability to appear for work on time follow directions from a supervisor interact well with co-workers understand and follow work rules and procedures comply with corporate policies goals and objectives accept constructive criticism establish goals and objectives and exhibit initiative and commitment.

• Strong understanding of healthcare domain concepts including FFS MCO pharmacy benefits and plan structures.

• Strong organizational and time management skills with the ability to manage multiple priorities and meet deadlines.

• Effective communication skills (written and verbal) to clearly document designs and explain complex concepts to stakeholders.

• Proficiency in tools such as Excel SQL (preferred) and ticketing/workflow systems (e.g. JIRA SalesForce).

Reasoning Ability

• Ability to interpret a variety of instructions furnished in written oral diagram or schedule form.

• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

Mathematical Skills

• Ability to apply concepts such as fractions percentages ratios and proportions to practical situations.

• Ability to work with mathematical concepts such as probability and statistical inference and fundamentals of plane and solid geometry and trigonometry.

Language Skills

• Ability to read analyze and interpret general business periodicals professional journals technical procedures or governmental regulations.

• Ability to effectively present information and respond to questions from groups of managers clients customers and the general public.

Competencies To perform the job successfully an individual should demonstrate the following competencies:

Composure

Decision Quality

Organizational Agility

Problem Solving

Customer Focus

Drive for Results

Peer Relations

Time Management

Dealing with Ambiguity

Learning on the Fly

Political Savvy

Physical Demands

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 accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger handle or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Ability to maintain clear near visual acuity at approximately 20 inches or less (i.e. close vision) to accurately read fine print view computer screens and handle small objects. Requires adequate color vision and depth perception to support safety and precision in detail-oriented tasks.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts high precarious places fumes or airborne particles toxic or caustic chemicals outdoor weather conditions risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers light traffic).

Work Location

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees colleagues clients or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours

This is a full-time non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore one must have the ability to work nights weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires no travel; however attendance may be required at various local conferences and meetings.

• Medical / Dental / Vision / Wellness Programs

• Paid Time Off / Company Paid Holidays

• Incentive Compensation

• 401K with Company match

• Life and Disability Insurance

• Tuition Reimbursement

• Employee Referral Bonus

To explore all that MedImpact has to offer and the greatness you can bring to our teams please submit your resume to is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego California. Our solutions and services positively influence healthcare outcomes and expenditures improving the position of our clients in the market. MedImpact offers high-value solutions to payers providers and consumers of healthcare in the U.S. and foreign markets.

To perform this job successfully the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed 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.

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities duties and skills required of personnel so classified.