Operations Systems Analyst II

 
Position: Operations Systems Analyst II

Job ID: 160829

Location: US-

Department: CONFIGURATION TEAM

Talent Area: Professional - Non-Clinical

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a-5p

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years.

Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation.

To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.



Summary:

We are searching for a Configuration Analyst -- someone who works well in a fast-paced setting. In this role, you will be responsible for the activities related to system updates, new health plan implementations and conversions within Business Operations. This role also designs configurations solutions to meet new business requirements and performs updates for either benefits, coding, contracts, fee schedules or claim editing rules in adherence with business policies and state requirements.

 

Think you’ve got what it takes?



Responsibilities :

Job Duties & Responsibilities

  • Analyzes incoming requests and designs configuration solutions to meet business requirements
  • Performs configuration changes for coding, contracts, benefits, fee schedules and claim editing rules as needed
  • Maintains thorough and concise documentation for tracking of all contracts, benefits, fee schedules and claim editing rule changes related to Change Control Management or issues for quality audit purposes
  • Identifies claims impacted by configuration changes done in the system and sends reports to the claims administration department for reprocessing
  • Performs system configuration design analysis associated with projects
  • Collaborate with the other team members to ensure that the documentation of user policies and procedures is updated timely as changes may occur
  • Analyzes configuration errors and identifies required modifications
  • Assists departmental leaders with upgrade testing as needed
  • Reviews and tests systems for conformance to functional and performance requirements


Qualifications:

Skills & Requirements

  • Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children’s, unless approved for a medical or religious exemption
  • High school diploma or GED required
  • Bachelor’s degree preferred
  • 2 years’ experience in managed care, claims processing, and/or configuration of benefits/contracts/fee schedules/medical policy payment rules required
  • A bachelor’s degree may substitute for the required work experience


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