Sr. Facets Configuration Business Analyst

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Full Time/Permanent

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The Sr. Facets Configuration Business Analyst will be responsible for assisting the Project Manager in gathering and documenting requirements for the Health Plan processes, including but not limited to claims processing, clinical editing, utilization management, enrollment, including conducting and reporting internal/external audits, reports and other documents; providing compliance advice to project teams and assisting with other departmental needs.

This position will lead Facets configuration design, system changes, and quality assurance testing. This resource will work with the Project Manager and users to develop or modify data, information and functions to meet the Health Plan’s needs. This individual must be flexible and hard working in a high-pressure environment and be able to work both independently and as part of a team with minimal or no supervision. This person will possess the ability and confidence to rely on experience and judgment to plan and accomplish goals in a constantly changing environment and will have demonstrated leadership experience and self-motivation.

Responsibilities:

  • Uses extensive Facets configuration, business knowledge and effective communication skills to facilitate and elicit requirements for projects.
  • Provide subject matter expertise and recommendations in assessing software projects and initiatives to support and enhance systems.
  • Identify opportunities that can improve efficiencies and business processes.
  • Create enhancement and change requests for projects.
  • Work closely with the stakeholders and business leaders to demonstrate the highest levels of customer service, communication, productivity, and professionalism.
  • Assist in assessment, planning, project communications, analysis, testing, training and implementation.
  • Develops business process artifacts (configuration design documents, process flow, work state diagrams, etc.) as they pertain to multiple functional areas.
  • Creates use cases, test scenarios, test cases, clearly communicate and apply testing methodologies to ensure quality outcomes.
  • Identifies, communicates and escalates risks and issues that may require changes to project plans or scope.
  • Organizes and synthesizes large amounts of information provided by stakeholders into presentation material.
  • Documents and implements configuration and process improvements and controls for traceability and future reuse.
  • Troubleshoots configuration and technical issues and identifies modifications needed to meet changing user and regulatory requirements.
  • Reviews change requests to ensure consistency and compatibility to existing systems and procedures including researching, validating and resolving issues for accurate processing.
  • Meets timelines as assigned and documents status of tasks including risks and issues.
  • Communicates and escalates information from all levels (leadership to end-users).
  • Assists in education and training end-users.
  • Monitors, reports and collaborates with users/departments to formulate corrective actions for issues.
  • Provides assistance with implementing enhancements and ensuring departments implement new processes supporting the changes.
  • Facilitates meetings and presentations effectively and professionally.
  • Supports development of expert users and mentors inexperienced users.
  • Demonstrates and promotes a positive approach to change.
  • Assists with the analysis and documentation of current state and future state.
  • Works directly with end users to evaluate customer or plan needs.
  • Prioritizes, plans, and organizes work with Project Manager to ensure deliverables are completed on time and produce high quality results.
  • Manages time and activities effectively and efficiently.
  • Participates in meetings with management to report progress, issues and possible resolution, and priorities.
  • Maintains up-to-date knowledge of current trends, and issues in healthcare, national and statewide standards and legislations, changing policies and procedures.

Qualifications:

  • Exemplary knowledge of Facets Configuration and a minimum of 10 year’s experience in a Facets Configuration Analyst position for many functional areas of health plans.
  • Associates or Bachelor’s Degree in Information Management or comparable work related experience.
  • Prefer 15 year’s experience in health plan administration with emphasis on claims and set-up as well as product or system support, testing of new workflow processes, maintenance of system databases and producing reports using MS Excel, MS Access, Crystal Reports and Microsoft Project (or other related project management software)

  • US

 
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