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Date Added: Sat 18/07/2020

Senior Facets/Networx Configuration Analyst

Getzville, New York, US
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Company: CENTENE

Job Type: Permanent, FullTime

Senior Facets/NetworX Configuration Analyst

Position Purpose:

Gather requirements and develop specification documents
Analyze, interpret, load, test and maintain configurable tables
Edit files and software that are utilized to support claim adjudication which includes, but is not limited to, claim adjudication rules edits, benefit plan support, and provider reimbursement rules
Assist in development and execution of testing scenarios and test conditions
Perform unit and/or end user testing for new configuration, programming enhancements, new benefit designs, new provider contracts, and software changes as necessary that affect claim adjudication rules
Proactively identify opportunities and recommend system solutions that increase automation, resolve system deficiencies and enhance claims processing and reporting to meet and exceed business requirements
Research and resolve claim problems or issues that are configuration related in a timely and accurate manner
Develop system queries to determine the scope of the problem and recommends possible solutions to management
Interact and coordinate system programming changes and schedules as necessary with the IS Business Analysts and Programmers
Assist with training new and existing staff

Create, update, test and maintain system configuration tables and files to support accurate claims adjudication in a multiple product, multiple state and managed care environment. Act as a liaison with specified user areas to define business requirements and processes for project deployment. Analyze information and develop specification documents to support updating, testing and maintaining configuration tables in the claims adjudication system. This role supports both product, benefit, and pricing in NYS for managed care, Medicare and Exchange Products.

Education/Experience:
Bachelor's Degree in Computer Science or related area or equivalent experience. 3+ years' experience in an automated medical claims environment and managed care/multiple product environment and 2+ years' experience in systems logic and testing is preferred. Experience with Facets, NetworX, SQL and Microsoft Office is a plus.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Information Technology

USA-New York-Getzville

Fidelis Care

Full-time
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