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Senior Configuration Analyst HealthRules Telecommute

Company: UnitedHealth Group
Location: San Francisco
Posted on: November 26, 2022

Job Description:

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

The Sr. HealthRules Configuration Analyst is a SME in Benefit Configuration and Pricing. The Sr. HealthRules Configuration Analyst will play an essential role in our clients' projects by leading HealthRules configuration design, system changes, and quality assurance testing. The Sr. HealthRules Configuration Analyst will work with the Project team to gather and document requirements; develop or modify data, information, and functions for the Health Plan processes; including, but not limited to, benefit configuration, claims processing, clinical editing, utilization management, and enrollment.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Uses extensive HealthRules configuration, business knowledge, and effective communication skills to lead, facilitate, and elicit requirements for projects
  • Assists with the analysis and documentation of current and future states, defining user requirements in the design of the future state workflows, to optimize system functionality
  • Develops business process artifacts (configuration design documents, process flow, work state diagrams, etc.) as they pertain to enterprise-level processes, spanning multiple functional areas. Documents and implements configuration and process improvements and control documentation
  • Reviews change requests to ensure consistency and compatibility to existing systems and procedures, including researching, validating, and resolving issues for accurate processing. Identifies, communicates, documents, and escalates information from all levels (end-users to leadership)
  • Troubleshoots configuration and technical issues, and identifies modifications needed to meet changing user and regulatory requirements
  • Assists in the education and training of end-users. Supports development of expert users, and mentors inexperienced users
  • Manages and facilitates meetings and presentations effectively and professionally to report progress and any issues. Prioritizes, plans, and organizes with Project Manager to ensure high quality results are completed on time

    You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

    Required Qualifications:

    • 5+ years of experience in multiple functional areas of health insurance
    • 3+ years of working as a HealthRules Configuration Analyst including testing of new workflow processes, maintenance of system databases
    • Experienced in eliciting requirements from business users to define and document project requirements, with the ability to perform business analysis and translate the outcome into definable software functionality
    • Experience required in all or most of the following: Medicaid, Medicare, ITS, FEP, knowledge of healthcare governmental strategy and business model, PPACA/HCR, Healthcare Exchange, EDI transactions, ICD-9 to ICD 10 conversion, HealthRules experience including technical knowledge of database supporting HealthRules
    • Ability to travel up to 50%; travel is required for this role and is generally less than 50% on average but may involve travel for short periods to satisfy specific client project requirements
    • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

      Preferred Qualifications:

      • Knowledge of computer software systems and applications and database set-up and management
      • Expert in the use of Word, Excel, Visio, and other tools used for documentation and reporting purposes including MS Excel, MS Access, Crystal Reports and Microsoft Project (or other related project management software)
      • Meticulous attention to detail. Solid -analytical, problem solving, negotiation, and collaboration skills, based upon goal and results orientation. Process driven, with proven ability to plan and execute multiple concurrent projects
      • Superb written and verbal English language communication skills, as well as interpersonal skills; able to communicate and influence peers, directors, and executives; to set clear expectations and realistic goals. Expert in the presentation of configuration ideas, status, solutions, and results
      • Superior task management skills, with the ability to work under pressure, independently, or as part of a team in situations in which multiple priorities are likely

        To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

        Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

        Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

        *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

        Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

        UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Keywords: UnitedHealth Group, San Francisco , Senior Configuration Analyst HealthRules Telecommute, Professions , San Francisco, California

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