Configuration Services Manager

Position: Configuration Services Manager

Location: Smithfield, RI  

Hybrid onsite: 4 days a week (Mon, Tues, Wed, Thurs)

Duration: 6 contract to hire

Interview Process: Onsite interview is required

This position is responsible for:

• Develops, implements, reviews, analyzes, and improves audit quality standards across claims and configuration programs and procedures, ensuring they are designed to drive accuracy, and quality results in support of the organizations vision, mission, and strategic goals.
• Management and oversight of staff resources in compliance with all departmental policies, procedures, and internal service level agreements
• Manages the Configuration Services Process, configures and builds necessary reports and establishes key metrics
• Manages the Configuration Services duties including but not limited to, review of requirements, oversight of use case and documentation creation, analysis of inventory to support the prioritization of corporate issues

Qualifications:

• Must have experience working in a managed care, health care work environment.
• Five (5) + years of related business analysis/business systems analysis/defect management experience or comparable business experience.
• At least 3 years of experience in a team lead or leadership role.
• Extensive experience in an insurance, medical and/or HMO environment using claims processing software.
• Must have experience with benefits, contracts, validation policies, modifiers, limits, and claims editing.
• HealthRules Claims Configuration experience is preferred.
• Strong use of data mining and analysis tools including SQL or similar tools that allow for data queries.
• Experience using Jira ticketing system.
• Experienced in the use of Cognos or a similar tool.
• Experience in demonstrating leadership, influence, and collaboration in a matrix-managed environment
• Demonstrated ability to manage multiple priorities simultaneously in a deadline driven environment with accurate resource and time estimates.
• Confident team builder and leader with strong motivational skills.  Adept in problem solving and resolving conflict
• Experience in mentoring and training colleagues.
• Must be accountable and be able to hold others accountable for the adherence to policies, procedures, and standards.
• Ability to liaise with business users, developers, stakeholders, analysts, and management.