Job Description
| AlohaCare was founded in 1994 through a group effort by local community health centers We are a local nonprofit health plan with a team of 200 employees serving more than 80000 QUEST (Medicaid) and Medicare members in Hawaii Today we are the thirdlargest health plan in Hawaii Our growth as a business is attributed to the quality of our employees AlohaCare employees share a passion for helping Hawaiirsquos most underserved communities receive quality health care Our employees find reward in helping others thrive In addition to building a positive presence in the community we are also committed to building a cultivating employee environment AlohaCare offers its employees very generous benefits including comprehensive medical dental drug and vision at a low premium cost 401k plan with employer match contribution paid holidays paid time off an employee referral program and much more AlohaCare employees have a strong desire to help each other AlohaCarersquos Lokahi team a staffdriven committee take great pride in finding ways to promote good health and development which create initiatives that boost morale and enhance our corporate culture Fairness honesty loyalty respectdignity and trust are the core values AlohaCare lives every day We are an organization striving to make a difference in our local communities The Systems Configuration Analyst Lead is responsible for overseeing the maintenance of the QNXT business application systems This includes performing complete and thorough analysis of business application system configuration andor operational procedures to find optimal solutions for change Implements efficiencies and configuration changes that will optimize business system configurations Supports QNXT and other business application system implementations and maintenance activities including configuration and documentation of all system files and options Responsible for overseeing and executing detailed test plans to ensure smooth production implementation Reviews test results with the Systems Configuration Analyst and Business Analysts to ensure implementation of changes meet project expectations Primary Duties Responsibilities and Competencies Works with Systems Configuration Analyst to define and prioritize projects Maintains QNXT configuration (reference files configuration module settings etc) Analyzes business requirements and objectives towards determining the optimal configuration of those requirements Creates complex design documents through the assessment of requirements Assesses alternatives to different designs and chooses best solution to fit business needs Performs complex work flow analysis and recommend alternatives based on one or more configuration solutions Keeps abreast of new version changes and the impact on configuration and maintain updates with Systems Configuration Analyst Performs detail unit testing on complex configuration changes Prioritizes and coordinates multiple tasks simultaneously and meets deadlines Performs complex data modeling and analysis with minimal oversight Adheres to departmental and corporate policies and procedures Attends improvement training programs when available and offered Applies practical thinking and decision making Supports team decisions collaborates with others to develop team solutions builds consensus and promotes teamwork through building consensus to develop mutual trust respect and commonality of goals Lead Duties Responsibilities Assists with interviewing potential new hires with the Sr Director of Plan Operations Tracks new hire training and retraining documentation for all department staff Provides regular feedback to employee regarding progress performance determined by department needs andor Sr Director of Plan Operationsrsquo direction Provides additional training when needed reports potential issues to Sr Director of Plan Operations Provides input to the Sr Director of Plan Operations related to staff job performance Monitors attendance and absences including prescreening of all PTO requests and timesheets and forwards to Sr Director of Plan Operations for signoff Maintains a calendar of approved PTO requests Establishes atmosphere of compliance with requirements within the department Becomes a subject matter expert (SME) of key requirements (contractual regulatory accreditation) related to departmental and pertinent interdepartmental activities with related reference materials supporting these activities Ensures all department work flows are in place Matches relevant PPrsquos used to support workflows Monitors departmental staff conformance to work flows and work flow effectiveness Identifies interdepartmental and organizational interdependencies Trains department staff on interdepartmental dependencies Participates in organizational workgroups as assigned Acts as point of escalation for nonstandard departmental transactions andor dissatisfied customers Assists with reassigning workloads during critical periods Required Education Skills Competencies and Qualifications Bachelorrsquos degree in business administration information science computer science industrial engineering or a relevant area or equivalent technical skills and experience Minimum 5 years of healthcare industry experience within MedicareMedicaid managed care hospital medical office or equivalent Possess problem solving and project management skills Must be able to take charge manage numerous projects and successfully coordinate projects with internal areas and external vendors Project team member oversight management andor supervisory experience required Excellent analytical and organization skills Detail oriented Excellent communication and organization skills Excellent interpersonal skills including the ability to work with all levels of personnel 35 years of claims processing experience Experience with SQLdata extraction tools Familiarity with data structures and data types Preferred Education Skills Competencies and Qualifications 13 years of QNXT Professional Certification highly desirable or equivalent QNXT configuration experience Previous experience with documentation of systems configuration highly desirable AlohaCare is an Equal Opportunity Employer |
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