Sr. Business Facets Configuration Healthcare Operations Analyst

General Summary:

Provide senior level Facets configuration expertise to the Business Configuration Team. Utilizing system analysis and business knowledge, coordinate requests of the customer base and other IT departments related to identifying and implementing short and long-term corporate business needs in the Facets system. Provide business level oversight of the detail design, configuration, testing and maintenance, of these initiatives.

Principal Duties and Responsibilities:

• Lead the planning and managing project activities of the assigned Team Members who evaluate the system impact of requests for enhancements, problem reports, and other special projects.
• Lead the interpretation, analysis, and organization of information and data necessary to prepare recommendations for enhancements to system applications/vendors.
• Establish and maintain contact with all assigned HAP departments to ensure that communication regarding workload and priorities is accomplished.
• Lead/Participate in corporate initiatives, ensuring the promulgation of corporate needs and priorities is distributed throughout Customer areas, and IT via the corresponding team leadership.
• Ensure continuous interaction with other IT departments to maintain data integrity and to assure coordination between IT efforts and the customer's needs, in order to expedite responses and resolution of system problems/issues.
• Monitor project scheduling, completion and perform ongoing quality review checks to ensure a quality implementation.
• Ensure that applications are designed and implemented based on finalized customer requirements.
• Lead BCT members to ensure proper procedures are followed when requests are received for maintenance, enhancements, and new development.
• Ensure that system specifications conform to Government Programs, and Regulatory Agency Standards.
• Develop procedures to address areas where systematic compliance is not attainable.
• Perform other related duties as assigned.

EDUCATION/EXPERIENCE REQUIRED:

• Bachelor's Degree in Computer Science, Business Administration or related field.
• Related and relevant experience may be considered in lieu of academic requirements. Related experience is defined as six (6) years’ experience in Health Care related business and/or claims processing system configuration.
• Three (3) years of group configuration analysis and design.
• One (1) year experience with Facets preferred.
• Seven (7) years of Health Care related business experience preferred.
• One (1) year of in project leadership role preferred.
• Demonstrated ability to research, analyze, design, plan, organize, coordinate, implement, and perform necessary follow-up and closure procedures for system related projects.
• Demonstrated ability to collect and prepare data for written/oral presentations.
• Demonstrated ability to communicate effectively.
• Demonstrated ability to interact with outside sources and maintain professional contacts.
• Excellent written and verbal communication skills are essential.
• Must be able to work effectively with persons of varying position levels and diverse interests.
• Configuration expertise on Facets Version 5.9 on an Oracle platform.
• Understanding of healthcare industry and managed care concepts.
• Knowledge of Windows, Microsoft Excel, Powerpoint and Word, Client Server Data Base Structure, Project Management Tools, Query Tools (SQL, Cognos etc.) and Implementation /Administration of Packaged Claims Processing Applications.
• A high level of human relations skills.
• Ability to adapt to a constantly changing environment.
• Strong knowledge of Facets group, billing, class/plan configuration.
• Strong knowledge of HAP's PCP assignment rules and network configuration.
• Involvement with large configuration projects preferred.
• Knowledge of Salesforce and Sales Automation workflow processes preferred.

Technical Operations Department additional preferred qualifications:

• Knowledge of the healthcare industry.
• Knowledge of Facets Group structure fundamentals, including class/Plan, is required.
• Experience in open enrollment processes preferred (new Plan/Product creation, passive enrollment, Mass member transfer etc.).
• Skilled in SQL, PL/SQL Programming under Oracle 11g and Unix Korn Shell scripting.
• Experience in Python scripting and/or programming preferred.
• Knowledge of Facets Configuration Migration Utility (CMU) and Facets Security Management Tool (SMT).