Location: Orange, California US
Job Number: 2038
Position Title: System Configuration Analyst
Systems Configuration Analyst (Provider)
Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.
By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.
The Provider Configuration Analyst is responsible for the activities related to system configuration and new health plan implementations, for accurately interpreting specific Health Plan Benefits, Contracts as well as additional business requirements and converting these terms to configuration parameters. This position is also responsible for coding, updating and maintaining benefit plans, division of financial responsibility (DOFR), provider contracts, fee schedules and various system tables through the user interface.
(May include but are not limited to)
Receives data from Sr. Management or designee for update of data in computer system.
• Analyze by applying knowledge and experience to ensure appropriate information has been received.
• Ability to analyze, interpret and implement business requirements.
• Ability to work in a consultative capacity.
• Load and maintain code sets, DOFR and benefit into computer system.
• Conduct Unit Testing when appropriate.
• Apply previous experience and knowledge to research and resolve claim/encounter issues, pended claims and update system as necessary.
• Suggest improvement processes to ensure systems are working more efficiently and improve quality.
• Ability to handle fluctuating volumes of work and be able to prioritize work to meet deadlines and needs of user community.
• Demonstrate ingenuity, self-reliance and resourcefulness. Able to take action without instructions using attained business knowledge which is applied consistent with current configuration and operations.
- Collaborate with internal departments to resolve and assist with system related issues/builds.
• Other duties, as assigned.
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:
- 2-3 years of related experience or equivalent combination of education and experience.
- High school diploma or general education degree (GED)
- Bachelor’s degree, preferred.
- Technical Skills:
- Intermediate level of knowledge in Microsoft applications
- Knowledge in medical terminology, ICD-9/10, CPT and HCPCS
- Business Skills:
- Ability to work independently as well as within a team
- Analytical and problem-solving skills
- Technical Skills:
- Attention to detail and accuracy
- Ability to meet department standards of turnaround time and quality
- Demonstrate consistent multi-tasking skills and planning for prioritizing workload with focus on deadlines
- Utilize effective verbal and written communication skills for external and internal departmental relations
- Communication Skills:
- Excellent verbal and written communication skills
- Ability to abide by Alignment's policies
- Maintain regular attendance based on agreed-upon schedule
- Ability to establish and maintain positive and effective work relationships with coworkers and Management.
- Work Environment
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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.
- 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.
- 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.
Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.
If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact firstname.lastname@example.org.
Location City: Orange
Location State: California
Community / Marketing Title: Configuration Analyst
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
We are dedicated to transforming the complex and confusing process of medical treatment in the United States so that every link in the health care continuum becomes more efficient, productive, and effective. We built a team of people who want to make a difference. Come join the team that is changing health care one person at a time.
We believe that great work comes from people who are inspired to be their best. We invite you to explore our wide variety of roles based on your unique experience.