Supervisor System Configuration

Job Summary:

The System Configuration Supervisor oversees the daily activities for the team responsible for the configuration of benefits plans in the system. This role will develop and share knowledge of system configuration, products, benefits, and quality. This role requires direct involvement with the team, analyzing changes of system design to determine the effect on the product design and function. This position will coordinate both internally and externally by providing information and reporting.  

Duties and Responsibilities:

• Effectively manage the performance of the System Configuration team by providing daily leadership and support; provide coaching, assistance, and direction, incorporating positive feedback and reward mechanisms
• Support the build and system configuration structure for operational use including client design interpretation, enrollment and billing configurations, table, and code creation, as well as module updates for successful client deployment and maintenance
• Hire and manage staffing levels to ensure continuous, quality production
• Conduct effective resource planning to maximize productivity and turn-around time
• Follow and maintain knowledge of Federal and State benefits regulations; implement changes regarding claims and billing requirements
• Review, revise, and monitor metrics to meet quality, time, service, and productivity goals
• Conduct regular meetings with staff toward improving performance, quality, and documentation
• Facilitate training for new hires and ensure the ramp-up to required metrics is on track.
• Provide direction for the triage, diagnosis, and resolution of issues with the intent of improving the system for business units, serve as an escalation point for all system issues
• Develop and revise testing scenarios, test conditions. Perform unit and/or end user testing for new configuration, software releases, programming enhancements, new benefit designs, new provider contracts, and software changes as necessary that affects processing. Suggest areas for improvement in system.
• Support creation of accurate, detailed requirement specification documents, user guides and functional specification documents
• Implement systems to capture and report on metrics, including any feedback or trends in product or service issues

Required Knowledge, Skills, and Abilities:

•  Associate’s degree or equivalent experience
• 3 + years health insurance plan build or system configuration experience in a supervisory role where HIPPAA and HITECH standards are utilized, preferably in a healthcare TPA
• Knowledge of Federal and State codes related to fiscal operations of healthcare services
• Knowledge of medical terminology and Diagnosis Codes (ICD-9 & ICD-10)
• Ability to analyze and interpret problems in claims adjudication based on system configuration; Determine the source of the problem and apply a solution 
• Must have an advanced level understanding of benefit administration software functionality, preferably in Javelina
• Solid working knowledge of standard computer applications including MS Word, Excel Outlook, and PowerPoint
• Demonstrated ability in using a computer which includes expert keyboard, navigation skills and learning new programs
• Communicate clearly and professionally with internal and external customers
• Work effectively as part of a team to achieve established outcomes; understand other’s roles and empower one another to take responsibility to be successful 
• Demonstrate a collaborative interaction with peers to reach a common goal as well as be a resource to team members and internal/external customers
• Pay close attention to detail in all aspects of the job
• Make decisions using available resources and sound judgment 
• Maintain confidentiality and discretion
• Identify and resolve problems in a timely manner, gather and analyzes information skillfully
• Effectively teach, coach, and counsel associates by effectively communicating and providing follow-up
• Open to other’s ideas and exhibits a willingness to try new things
• Demonstrate accuracy and thoroughness; monitor work to ensure quality
• Prioritize and plan work activities to use time efficiently
• Adapt to changes in the work environment, manage competing demands and is able to deal with frequent change, delays, or unexpected events
• Act in such a way to instill trust from management, other associates, as well as customers

Physical and Cognitive Demands: 

The demands described here are representative of those necessary for an employee to successfully perform the essential functions of this job. Reasonable accommodation can be made to enable individuals with disabilities to perform the essential functions.

• Constant: Talk, hear, speak, and use hands and fingers to operate a computer, telephone, keyboard/mouse; occasionally move about the office
• Constant: Visual ability such as close vision, distance vision, color and peripheral vision, depth perception and ability to adjust focus 
• Occasional: Lift and/or move up to 30-50 pounds
• Constant: Regular, predictable attendance in the office is required
• Constant: While performing the duties of this job, the employee is regularly sitting for the full shift
• Constant: The cognitive skills needed to complete tasks include abilities such as learning, remembering, focusing, categorizing, and integrating information for decision making, problem-solving, and comprehending. 

Work Environment: The work environment described is representative of what must be met by an employee successfully perform the essential functions of this job.  

• The physical environment is indoors in a controlled climate, office setting. The noise level may be low to moderate.

The duties described are representative, but not restrictive of tasks that may be assigned or of the abilities required to do the job. The description is subject to change at any time. Other related duties may be assigned. This description does not alter the at-will status of employment.