CareFirst Careers

Con Ben Configuration Analyst

Resp & Qualifications

PURPOSE:

The incumbent is responsible for fully understanding necessary functions and processes to support the contract build function, assessing business solutions that identify and strengthen the operational effectiveness and accuracy of the contract build as it relates to the initial build and the maintenance of existing builds. The incumbent will be required to be an active participant in activities that support internal and external customers and their projects and inquiries, in addition to delivering approved logic that will be used to create contracts for required contract generation and distribution to groups and members. The Analyst will serve as the Subject Matter Expert for the department and consult on matters that impact business area and software development teams.

PRINCIPLE ACCOUNTABILITIES: 

Under the direction of the Supervisor or Manager, the principle duties and responsibilities include, but are not limited to, the following:

Operations Support
• Actively participate in planning sessions to ensure that the team’s tactical and strategic operational goals are aligned with other CareFirst department’s staff, IT, and clients.
• Provide input to the development of project plans for day-to-day changes, corporate initiatives, and other projects.
• Provide feedback for development of resource estimates, timeframes, and provide input to cost/benefit analysis that will be used to develop ROI business cases and budgets for initiative projects.
• Support and/or perform corporate processes for systems and process change management, spanning request submission, review, validation, prioritization, scheduling, and status reporting.
• Provide support for project configuration, testing and implementation where required.
• Review corporate communications, promotional literature, internal documents, ecommerce documents and training materials to ensure contract integrity.

 Annual Contract Build/Regulatory Support
• Ensure successful completion of day-to-day changes, corporate initiatives, and other projects by completing the activities necessary to satisfy the requirements of the implementation memos. This includes, but is not limited to terminating existing forms, cleaning, importing and testing new forms.
• Creating new logics (rules) and updating the changes in existing logics. Revising the Database Tables to reflect current requirements, building new product templates and updating code strings/product IDs and creating the required sample contracts that support the implementation memo.
• Updating and providing the applicable logs and charts relevant to Work Requests.
• Meeting critical deadlines and/or timely delivering/providing the appropriate level of analysis that support the requirements or specifications and implementation impact assessment that is due.
• Also provides support for the successful completion of other related tasks, such as the daily maintenance of issue logs, system control files, benefit files, and tracking/updating user documentation.
• Utilizes team controls and processes for production systems support and monitoring, which includes issue analysis, tracking, and resolution.
• Serves as a subject matter expert in areas of system/business expertise.

Contract Production Support
• Reviews, edits, and performs analysis of business systems, processes, and documentation making necessary corrections to improve the performance and accuracy of existing configuration builds, processes, and documentation.
• Research and resolve issues that have been reported to team through emails and other means in a timely manner.  This includes updating BSBS/Product ID Code String request that are part of standard and non-standard 200+ requests, MIA/Nurse Appeals, and locking or unlocking groups from the system library Nonstandard list from the Database Tables. 
• Addressing Contract inquiries from other areas that are appropriate that include Fully Insured Groups, validating documents being used in current contracts are relevant for the contract year implemented. 

System and Process Improvements
• Proactively participate/lead in the technical research and business process improvements that help identify opportunities for improved systems and/or business processes.

SUPERVISORY RESPONSIBILITY: 

The incumbent has no direct reports but may review the work of Contractors and may serve as a task leader for projects.


SCOPE DATA:
The incumbent is directly accountable for supporting the quality and cost-effective development and maintenance of various mission-critical systems and/or programs at CareFirst. Failure to perform the job well can result in longer or problematic system implementations and business definition defects, resulting in ineffective or incorrect processes, corporate inability to provide critical or timely data to internal and external customers, vendors, providers and other business partners, customer complaints, decreased performance scores, and financial penalties. 

Minimum Qualifications:
Required

  • This position requires a bachelor’s degree or equivalent work experience. 
  • The candidate should have a minimum of 3 years of experience in managed healthcare claims or member services utilizing systems that support the administration of the related functions.
  • At least 2 years of experience providing analytical support of business processes and/or systems to increase/enhance operational effectiveness.
  • Demonstrated systems experience to include working on contract generating platforms along with basic understanding of business rules along with contract language and product knowledge. Thorough understanding of BCBS contract language systems and reports is necessary. 
  • Detailed knowledge of benefits packages, membership and claims systems. 
  • Knowledge of administrative and internal procedures is essential, including internal/external operating policies, business rules by product and platform, medical policy and BCBSA standards, MIA/VBOI regulations and governance, SAS70 and Sarbanes Oxley compliance.


Abilities/Skills:

Relevant business and systems subject matter expertise.  Must have the ability to work independently and as part of a team. The incumbent will have excellent interpersonal skills with the ability to lead problem-solving discussions. Attention to detail and excellent analytical and problem-solving skills.  The incumbent should also have a working knowledge of Project management and working knowledge of the Software Development Life Cycle skill sets.  Excellent written and verbal communication skills, excellent organizational skills and ability to set priorities and handle multiple projects concurrently are also required.  Extensive PC skills including Microsoft office software such as Word, Excel, and PowerPoint are required for daily work tasks.

The incumbent must be able to effectively work in a fast paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.  Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Preferred:

SOP writing experience. Experience in creating and documenting business processes and workflow along with experience with both mainframe and client/server technology is preferred.  Training experience is also encouraged. 
 

 

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Department

Department: Contract Management 

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer.  It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Hire Range Disclaimer

Actual salary will be based on relevant job experience and work history.

Closing Date

Please apply before: 6/17/2020

Federal Disc/Physical Demand

Note:  The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

PHYSICAL DEMANDS:

The employee is primarily seated while performing the duties of the position.  Occasional walking or standing is required.  The hands are regularly used to write, type, key and handle or feel small controls and objects.  The employee must frequently talk and hear.  Weights of up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship

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