Sr. Configuration Analyst - EPIC Tapestry

The Configuration Analyst, Sr. role is responsible for the activities related to advanced system updates that can impact more than one piece of the configuration. New health plan implementations and conversions within Business Operations. Designs configurations solutions to meet new business requirements and performs updates for benefits, coding, contracts, fee schedules and claim editing rules in adherence with business policies and state requirements.

Performs daily configuration changes in claim adjudication systems.

Performs system configuration design analysis associated with multiple areas of configuration with one project.

Analyzes configuration errors and identifies required modifications.

Supports new system implementations and upgrades.

Knowledge and Skills

Knowledge in at least three of the areas under the purview of Med Policy Configuration: benefits, contracting, coding, fees schedules, or claim edits (CES).

Knowledge of current managed care business practices and adjudication systems used by the Health Plan.

A working knowledge of the healthcare industry, preferably health insurance/managed care.

Collaboration, written and verbal communication, detailed analytical and organizational skills; ability to manage time with competing priorities; self-motivation; leadership; and ability to work independently with minimum supervision.

Additional required knowledge includes claims processing, configuration of contracts, benefits, fee schedules, and Claims

Editing System; ability to interpret business requirements into system coding edits, and testing of configuration builds. Two or more EPIC Tapestry certifications strongly preferred.

Required:

H.S. Diploma or GED

4 years' experience: Managed care, claims processing, and/or configuration of benefits/contracts/fee schedules/medical policy payment rules. A bachelor's degree may substitute for two (2) years of required work experience.

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.

To join our community of 15,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities.

Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.