QNXT Configuration Manager, Denver Health Medical Plan

22 Jun 2024

Vacancy expired!

Remote opportunity for Colorado Resident

Job Summary

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.

Responsibilities

1.Manages a team of professional Configuration Analysts.

2.Manages updates to functional, non-functional and technical requirements and the associated impacts

3.Develop post-implementation oversight processes & workflows

4.Develop and deliver presentations to management and staff related to projects\equirements

5.Obtain business approval for requirements

6.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.

31.Develop high-level functional & non-functional requirements

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.

Education

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.

LocationDenver Health Medical Plan

Shift Days

Work TypeFull time

Pay Range

Minimum: $112,400.00

Midpoint: $143,300.00

Maximum: $174,300.00

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, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 18 school-based health centers, Rocky Mountain Poison and Safety, a Public Health department, an HMO and The Denver Health Foundation.

As Colorado's primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.

Located near 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. As an EOE, Denver Health 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.

  • ID: #43483818
  • State: Colorado Denver 80201 Denver USA
  • City: Denver
  • Salary: USD TBD TBD
  • Job type: Contract
  • Showed: 2022-06-22
  • Deadline: 2022-08-20
  • Category: Et cetera