Configuration Analyst

Job Number: 2038

Workplace Type:

Position Title: System Configuration Analyst

External Description:

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.

 

Position Summary:

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. 

General Duties/Responsibilities:

(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. 

Supervisory Responsibilities:

None.

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.

1. Minimum Experience:
   1. 2-3 years of related experience or equivalent combination of education and experience.
2. Education/Licensure:
   1. High school diploma or general education degree (GED)
   2. Bachelor’s degree, preferred.
3. Other:
   1. Technical Skills:
      1. Intermediate level of knowledge in Microsoft applications 
      2. Knowledge in medical terminology, ICD-9/10, CPT and HCPCS 
   2. Business Skills:
      1. Ability to work independently as well as within a team
      2. Analytical and problem-solving skills

• Attention to detail and accuracy

1. Ability to meet department standards of turnaround time and quality
2. Demonstrate consistent multi-tasking skills and planning for prioritizing workload with focus on deadlines
3. Utilize effective verbal and written communication skills for external and internal departmental relations

1. Communication Skills:
   1. Excellent verbal and written communication skills 
   2. Ability to abide by Alignment's policies 

• Maintain regular attendance based on agreed-upon schedule 

1. Ability to establish and maintain positive and effective work relationships with coworkers and Management. 

1. Work Environment
2. 1. 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 [email protected].

City: Orange

State: California

Location City: Orange

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].