Configuration Architect Trainee

Hawaii Medical Service Association in Honolulu, HI

  • Type: Full Time
position filled

1.  Designs, develops, tests & implements low & medium complexity QNXT configuration & CES solutions:

  •  Complies with architecture principles, policies and standards.
  •  Designs QNXT and/or CES configuration components as solutions and develops & presents applicable design documentation
  • Learns to lead the configuration analysis & design team through the design & development process.
  • Understands and recommends the use of new or existing QNXT/CES components and appropriate changes to them.
  • Complies with quality standards and procedures.
  • Conducts unit testing to ensure application meets specifications. Documents unit testing results according to Life Cycle standards.
  • Utilizes Claims Test Pro, or other testing tools, where appropriate.
  • Participates in integration and/or systems acceptance testing.
  • Utilizes the Configuration Management Utility (CMU) or other tools to stage, test & promote full solutions where appropriate.
  • Utilizes approved SQL scripts for solution deployment where appropriate, following applicable procedures and documentation.
  • Makes components production ready by moving them to libraries, completing build sheets & following procedures, when solutions cannot be deployed via scripts or the CMU.
  • Utilizes SQL query programming through the adjustment of existing SQL, the development of new SQL or the Claims Dynamic SQL Query to assist with research, analysis, design and QA of solutions.
  • With minimal guidance from supervisor, organizes, plans, implements and tracks own assignments through status reports or other project planning method
  • Has increasing opportunities to serve as a liaison with internal customers based on project activities or as assigned to gain business knowledge or cross-functional training

2.  Supports Triage, Production Follow-up and other necessary claims research & reporting for the Department as assigned, adhering to established SLA's where appropriate: 

  • Resolves assigned triage problems in accordance with duties a & b above
  • Develops low & medium complexity SQL queries as interim solutions for problems and delivers to IS for production scheduling
  • Develops low & medium complexity SQL queries to identify claims for re-processing and provides required information to either or both the Claims Services Adjustment Unit or the Recovery Unit
  • Develops low & medium complexity SQL queries as assigned to support required QNXT/Claims research
  • Drafts and socializes desk top procedures as appropriate

 3.  Analyzes business requests and/or problems including, but not limited to, benefit plans, products, medical/payment policies, provider contracts, reimbursement methods, fees or medical coding. Learns to research the current state of QNXT & CES configuration, along with related processing, desktop, and system procedures in order to contribute to the requirements development portion of projects & larger BAU assignments. Communicates & interacts pro-actively with various internal customers, BCIS Management/Leads and/or Business Analysts to:

  • Ensure request is complete and the scope & requirements are understood
  • Assist in the project planning process with Project Management & other team member
  • Ensure any relevant current issues are raised for consideration & decision making
  • Recommend changes to requirements in light of research in order to increase and/or improve efficiency, member or provider satisfaction
  • Agree on testing and production implementation dates
  • Ensure priority is understood in light of other work in the queue
  • Understand and define completion & acceptance criteria with customers
  • Actively contribute in the requirements elicitation and documentation phase of the work request
  • Learns to lead the configuration research & design team during the requirements elicitation
  • Gain business and domain knowledge as needed

4.  You may be assigned work not outlined in your job description based on department workload, skill development opportunities, or other task as management deems necessary to support the organization


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