In this role the Manager, Configuration will manage a team of QNXT configuration analysts. Responsible for accurate and timely implementation and maintenance of critical information on claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to each database. Validate data to be housed on databases and ensure adherence to business and system requirements of customers as it pertains to contracting, benefits, prior authorizations, fee schedules, and other business requirements.
*Remote opportunity for qualified Colorado resident.
1. Manages a team of professional Configuration Analysts.
2. Manages updates to functional, non-functional and technical requirements and the associated impacts
4. Develop and deliver presentations to management and staff related to projects\requirements
5. Obtain business approval for requirements6. Design, develop, implement and support software solutions using PowerShell.
7. Design, develop, implement and support software solutions using MS SQL Server (TSQL)
8. Follow the Software Development Lifecycle (SLDC)
9. Use Agile Methodologies to incrementally create and implement software solutions.
10. A desire to investigate and potentially implement agile development tools to enable faster, more consistent delivery of solutions.
11. Discover and document existing business process manuals and workflows
12. Develop and document required changes to business process manuals and workflows
13. Suggest improvements to business process workflows
14. Develop\update training materials as necessary
15. Lead training sessions as necessary
16. Collaborate with Project Manager to develop project tasks\durations related to requirements activities
17. Provide status reporting
18. Assist in development of test cases and scenarios
19. Assist with or perform testing activities as needed
20. Validate accuracy and completeness of traceability matrix from requirements to test cases
21. Support go-live events as needed
22. Conduct post-implementation review to ensure all requirements have been met
23. Independently manage small initiatives
24. Utilize vendor expertise to develop requirements that maximize system performance and functionality
25. Participate in design review sessions related to new requirements
26. Promotes positive interpersonal (customer) relationships with fellow employees, physicians, patients and visitors. Treats these individuals with courtesy, dignity, empathy and respect; consistently displays courteous and respectful verbal and non-verbal communications.
27. Works with the business and project development teams to assess and recommend the appropriate configuration design, solutions and methodology for new and existing business.
28. Develops standard operating procedures and guidelines for the Configuration team.
29. Ensures service level agreements are met.
30. Provides status reports and project updates to management and stakeholders.
32. Create Standards for documentation, processes, development and workflows
33. Facilitate requirements gathering sessions
34. Develop and document and\or facilitate the development and documentation of detailed business, technical, system, and/or workflow requirements.
35. Other duties as assigned.
Knowledge, Skills and Abilities
1. Ability to read and interpret benefit contract specifications and regulatory requirements as required.
2. Ability to access and analyze data in information systems and compile reports for internal and external use.
3. Ability to apply judgment to complex situations and make sound decisions.
4. Demonstrate effective leadership skills.
5. Ability to implement operational policies and procedures in collaboration with other key personnel; administer programs or interrelated activities of a complex nature; achieve set operational and individual goals; adapt to, and implement industry innovations and best practices to ensure maximum operational efficiency; and, demonstrate effective and efficient communication skills, both written and oral.
6. Ability to configure Benefits ,Contracts, Provider, Member and others in the QNXT claims platform
Computers and Technology
1. Sound knowledge of Microsoft Office applications, Visio and Microsoft SharePoint.
2. Excellent presentation skills using Microsoft PowerPoint.
3. Intermediate to advance level ability to develop utility scripts in PowerShell.
4. Intermediate to Advance level ability to develop SQL scripts for MS SQL Server.
5. Technical understanding of various software technologies, tools and platforms.
6. Knowledge of specific Health Insurance industry IT applications is preferred.
7. Skills in compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data.
8. Programming\Development skills preferred.
1. Bachelor's Degree required.
2. Five years of benefit configuration experience (e.g. QNXT) required.
3. Two years of supervisory or leadership experience required.
Location Denver Health Medical Plan / Remote Opportunity
Work Type Full time
All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, efficient, high-quality academic health care system that is considered a model for the nation. The Denver Health system includes the Rocky Mountain Regional Level I Trauma Center, a 525-bed acute care medical center, Denver's 911 emergency medical response system, 8 family health centers, 15 school-based health centers, the Rocky Mountain Poison and Drug Center, the Denver Public Health Department, an HMO, and The Denver Health Foundation.
As Colorado's primary safety net institution, Denver Health is a mission-driven organization that has provided more than $3.3 billion in care for the uninsured in the last ten years. Denver Health is a leader in performance and quality improvements and remains financially secure, in part, due to its nationally recognized implementation of lean principles in healthcare. Denver Health is a major resource to the community, serving approximately 185,000 individuals and 67,000 children a year.
Located just south of downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).
"Denver Health is committed to provide equal treatment and equal employment opportunities to all applicants and employees. Denver Health is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class."
Internal Number: 1856
About Denver Health
Take your career to the next level at Denver Health, where we offer a robust benefits package and endless opportunities for growth. Denver Health is a nationally-ranked, locally-trusted, premier healthcare institution located in the heart of Denver, Colorado.Twenty-five percent of all Denver residents, or approximately 150,000 individuals, receive their health care here. We are known as an integrated health care system that encompasses multidisciplinary academic specialties, a community health system, a level I adult trauma center, pediatric emergency and urgent care center home to Denver Public Health and many of the nation’s leaders in medicine.