Lead Configuration Solutions Analyst

Independence Blue Cross; Philadelphia (Philadelphia County); On-site; USD 95,000 - 135,000; Full time

Job summary

Independence Blue Cross in the Philadelphia area seeks a Lead Configuration Solutions Analyst to drive end-to-end configuration strategies for Health Rules and Front Office platforms. You will bridge business and IT to implement feasible solutions, analyze requirements, and support operations across claims, enrollment, and billing.

Join a team focused on process optimization, data analytics, and cross-functional collaboration.

Qualifications

• Bachelor’s degree in related field preferred.
• HealthRules Payer experience required.
• Experience in healthcare industry preferred.
• Strong problem-solving abilities.
• Ability to work in Hybrid model in Tri-State Area.

Responsibilities

• Develop end-to-end configuration strategies for Health Rules and Front Office systems.
• Analyze feasibility and define solution concepts for new business requests.
• Develop requirements and functional specs to meet business needs.
• Resolve tickets and enhancements in ServiceNow according to SLAs.
• Identify process improvements across operations with partners.
• Retrieve and analyze data to support decision-making and identify trends.
• Understand system changes and determine if new processes are required.

Skills

Analytical skills

Communication skills

Microsoft Office

Project management tools

System integration understanding

Education

Bachelor’s degree preferred

Tools

HealthRules Payer

ServiceNow

BizTalk

Job description

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

At Independence Blue Cross everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

TheLead Configuration Solutions Analystworks on end-to-end configuration solutions and provides optimization support to all Operations teams by bridging the gap between business and technology. This includes in depth benefit coding and analysis in HealthRules Payer.

Business Configuration Solutions– the Configuration Solutions Analyst is responsible for developing end-to-end configuration strategies of the Health Rules and Front Office System platforms. This requires knowledge and experience pertaining to the hierarchy of system and business rules and their integration and impact to other downstream applications. (i.e.: portals, BizTalk, vendor file feeds, DART, provider and enrollment database, CABs, etc.)

A. Business Configuration Solution Delivery– Analyze, determine feasibility, and prove solution concepts for new business, operations enhancement requests, state and federal mandates, BPO/Partnership implementation or introduction of new products

B. Projects and Requirements– Portfolio project work will be assessed, and if feasible, requirements and/or functional specs will be developed to meet the business need

Operations Support –The Lead Configuration Solutions Analyst isresponsible for collaborating with their teammates and peers to improve business area daily processes and tasks within the Health Rules and Front Office System applications. Also responsible for determining system and process feasibility for new clients, lines of business, and/or products

A. Ticket Resolution – Focus on resolving tickets and enhancement requests in ServiceNow accurately according to SLAs

B. Process Improvements– Identify and define process improvements across operations with our business partners (sales/account management, claims, billing and enrollment, clinical services, IT, product, etc.)

C. Operational Analytics– Retrieve, analyze, organize, report and configure data as needed to support decision making and optimization within the operations business areas. In addition, identifying global trends in operational issues

D. System Releases– Understand system changes and impacts and determine if new processes or configuration is required

Responsibilities include, but are not limited to:

• Implement improved processes, best practices in configuration and management methods to generate higher ROI and workflow optimization
• Must have above average analytical skills
• Provide support to Configuration Solutions Analyst
• Must have a global view of interactions with other systems or business needs to determine levels of impact
• Demonstrated experience using Microsoft office products and project management tools
• Proven effective communication and analytical skills required to covey complex ideas and concepts to users, business systems analyst, IT and officer level management
• Must be detail oriented and understand corporate objectives. Ability to follow through on project life cycle while maintaining target deadlines. Must be able to develop contingency project plans
  

Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals. If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health.

At Independence Blue Cross everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace.Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

TheLead Configuration Solutions Analystworks on end-to-end configuration solutions and provides optimization support to all Operations teams by bridging the gap between business and technology. This includes in depth benefit coding and analysis in HealthRules Payer.

Business Configuration Solutions– the Configuration Solutions Analyst is responsible for developing end-to-end configuration strategies of the Health Rules and Front Office System platforms. This requires knowledge and experience pertaining to the hierarchy of system and business rules and their integration and impact to other downstream applications. (i.e.: portals, BizTalk, vendor file feeds, DART, provider and enrollment database, CABs, etc.)

A. Business Configuration Solution Delivery– Analyze, determine feasibility, and prove solution concepts for new business, operations enhancement requests, state and federal mandates, BPO/Partnership implementation or introduction of new products

B. Projects and Requirements– Portfolio project work will be assessed, and if feasible, requirements and/or functional specs will be developed to meet the business need

Operations Support –The Lead Configuration Solutions Analyst isresponsible for collaborating with their teammates and peers to improve business area daily processes and tasks within the Health Rules and Front Office System applications. Also responsible for determining system and process feasibility for new clients, lines of business, and/or products

A. Ticket Resolution – Focus on resolving tickets and enhancement requests in ServiceNow accurately according to SLAs

B. Process Improvements– Identify and define process improvements across operations with our business partners (sales/account management, claims, billing and enrollment, clinical services, IT, product, etc.)

C. Operational Analytics– Retrieve, analyze, organize, report and configure data as needed to support decision making and optimization within the operations business areas. In addition, identifying global trends in operational issues

D. System Releases– Understand system changes and impacts and determine if new processes or configuration is required

Responsibilities include, but are not limited to:

• Implement improved processes, best practices in configuration and management methods to generate higher ROI and workflow optimization
• Must have above average analytical skills
• Provide support to Configuration Solutions Analyst
• Must have a global view of interactions with other systems or business needs to determine levels of impact
• Demonstrated experience using Microsoft office products and project management tools
• Proven effective communication and analytical skills required to covey complex ideas and concepts to users, business systems analyst, IT and officer level management
• Must be detail oriented and understand corporate objectives. Ability to follow through on project life cycle while maintaining target deadlines. Must be able to develop contingency project plans
  

Qualifications - External

Qualifications -

· Bachelor’s degree in related field preferred

· HealthRules Payer experience required. Candidate will not be considered if they don't have this experience.

· Experience in Healthcare required

· Proven problem-solving abilities that allow you to understand root cause, provide impact assessment, and follow through on process improvement to ensure there is no additional exposure for the organization/client

· Inspires and motivate others to support a culture of accountability/execution by setting clear expectations and measuring success though performance which will drive organizational results

Hybrid

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Qualifications -

· Bachelor’s degree in related field preferred

· HealthRules Payer experience required. Candidate will not be considered if they don't have this experience.

· Experience in Healthcare required

· Proven problem-solving abilities that allow you to understand root cause, provide impact assessment, and follow through on process improvement to ensure there is no additional exposure for the organization/client

· Inspires and motivate others to support a culture of accountability/execution by setting clear expectations and measuring success though performance which will drive organizational results

Hybrid

Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Inclusion and Belonging

At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com . We’re revolutionizing health care, and our focus is on you!

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.