CCO Configuration Architect - Business Integration
Job Details
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Rewards
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
www.ucare.org/careers/
EOE/AA
ABOUT UCARE
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 14 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
CCO CONFIGURATION ARCHITECT - BUSINESS INTEGRATION
Work Location: Work from Home or Office for Your Day
Position Description
As the Configuration & Claims Operations (CCO) Configuration Architect - Business Integration, you will be responsible for the design and oversight of CCO Technical processes and systems, including Axiom TransSend, HealthRules, and Optum PPS and CES. Guide initiatives to maximize business value and participate in the architecture of configuration solutions that align with business strategy. Responsible to assist in the development of scalable business practices and enhancements of manual processes through automation. Bring subject matter experts together, collaborate, creating solution options and recommendations across the body of new requests, break/fix, and projects. Partner with IT and business stakeholders on the development and architecture of best practices for business functions and integrations and the implementation of new functionality to support business initiatives. Develop business testing strategies, and partner with IT QA's on technical testing, for accurate system deployment and work with stakeholders at all levels throughout the organization for the successful interpretation and implementation of complex requirements. Drive resolution of defects, promote system enhancements, and drive upgrade decisions and activity, including utilization of new functionality, and process and product enhancements.
• Architect scalable business practices and configuration solutions for Optum PPS and CES, and TransSend, maintaining an understanding of current business practices, configuration, and system integration. Partner with HealthRules Configuration Architects on solutions to maximize value across integrated systems.
• Collaborate with various departments and technical teams for the development of automated and refined processes to support operational efficiencies.
• Track system defects and enhancements for HealthRules, EDI system vendors, and Optum products. Work with business units, IT, and external parties to define ROI/benefits, plan releases, and optimize system performance.
• Evaluate new system releases, document changes, assess impacts, and seek feedback from UCare stakeholders. Participate in system upgrade activities, as needed.
• Assist in the development of test scenarios for changes and/or projects. Manage the timely resolution of open testing bugs and issues. Develop and monitor postproduction audit reports to ensure the intent of change and/or project requirements is being met.
• Create and maintain documentation related to work processes, system flows, and end-to-end integrations.
• Collaborate with CCO and IT Business Analysts, UAT and QA to create detailed functional requirements that support and align to business requirements and testing scenarios.
• Recommend and draft new and updated procedures to maximize the use of HealthRules-integrated systems, and other third-party products to improve efficiency.
• Perform training and knowledge sharing to stakeholders, leaders, and team members, as needed.
• Inform leader and peers of business and functional changes that will impact UCare. Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner.
• Partner with business owners of systems that integrate with claims applications to assess upstream and downstream impacts of outside system changes. Track upgrade and deployment activities of integrated systems and work with project manager and/or business owners to mitigate risk.
• Other projects and duties as assigned.
Education
Bachelor's degree in business or health care preferred; demonstrated work experience may be considered in lieu of degree.
Required Experience
Five years of healthcare payer system experience. Two years of architecture or design role experience. Must possess working knowledge of managed care operations, EDI, and claims adjudication. Has successfully implemented and had oversight of new system functionality and the implementation of configuration related to business strategies or market expansion.
Preferred Experience
Strong knowledge of government programs, regulations and benefits. Experience with the HealthRules platform, Optum PPS, CES, and/or Rate Manager, and Axiom TransSend. Business Analysis and/or Project Management experience, and solid operational experience.
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 06/01/2023
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.
UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
Rewards
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
www.ucare.org/careers/
EOE/AA
ABOUT UCARE
UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 14 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
CCO CONFIGURATION ARCHITECT - BUSINESS INTEGRATION
Work Location: Work from Home or Office for Your Day
Position Description
As the Configuration & Claims Operations (CCO) Configuration Architect - Business Integration, you will be responsible for the design and oversight of CCO Technical processes and systems, including Axiom TransSend, HealthRules, and Optum PPS and CES. Guide initiatives to maximize business value and participate in the architecture of configuration solutions that align with business strategy. Responsible to assist in the development of scalable business practices and enhancements of manual processes through automation. Bring subject matter experts together, collaborate, creating solution options and recommendations across the body of new requests, break/fix, and projects. Partner with IT and business stakeholders on the development and architecture of best practices for business functions and integrations and the implementation of new functionality to support business initiatives. Develop business testing strategies, and partner with IT QA's on technical testing, for accurate system deployment and work with stakeholders at all levels throughout the organization for the successful interpretation and implementation of complex requirements. Drive resolution of defects, promote system enhancements, and drive upgrade decisions and activity, including utilization of new functionality, and process and product enhancements.
• Architect scalable business practices and configuration solutions for Optum PPS and CES, and TransSend, maintaining an understanding of current business practices, configuration, and system integration. Partner with HealthRules Configuration Architects on solutions to maximize value across integrated systems.
• Collaborate with various departments and technical teams for the development of automated and refined processes to support operational efficiencies.
• Track system defects and enhancements for HealthRules, EDI system vendors, and Optum products. Work with business units, IT, and external parties to define ROI/benefits, plan releases, and optimize system performance.
• Evaluate new system releases, document changes, assess impacts, and seek feedback from UCare stakeholders. Participate in system upgrade activities, as needed.
• Assist in the development of test scenarios for changes and/or projects. Manage the timely resolution of open testing bugs and issues. Develop and monitor postproduction audit reports to ensure the intent of change and/or project requirements is being met.
• Create and maintain documentation related to work processes, system flows, and end-to-end integrations.
• Collaborate with CCO and IT Business Analysts, UAT and QA to create detailed functional requirements that support and align to business requirements and testing scenarios.
• Recommend and draft new and updated procedures to maximize the use of HealthRules-integrated systems, and other third-party products to improve efficiency.
• Perform training and knowledge sharing to stakeholders, leaders, and team members, as needed.
• Inform leader and peers of business and functional changes that will impact UCare. Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner.
• Partner with business owners of systems that integrate with claims applications to assess upstream and downstream impacts of outside system changes. Track upgrade and deployment activities of integrated systems and work with project manager and/or business owners to mitigate risk.
• Other projects and duties as assigned.
Education
Bachelor's degree in business or health care preferred; demonstrated work experience may be considered in lieu of degree.
Required Experience
Five years of healthcare payer system experience. Two years of architecture or design role experience. Must possess working knowledge of managed care operations, EDI, and claims adjudication. Has successfully implemented and had oversight of new system functionality and the implementation of configuration related to business strategies or market expansion.
Preferred Experience
Strong knowledge of government programs, regulations and benefits. Experience with the HealthRules platform, Optum PPS, CES, and/or Rate Manager, and Axiom TransSend. Business Analysis and/or Project Management experience, and solid operational experience.
THE UCARE DIFFERENCE
The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
JOB POST DATE: 06/01/2023
Company
UCare offers Medicare, Medicaid, Individual and Family health plans – powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.
WORKING AT UCARE
Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.
Our strong culture has established UCare as a Star Tribune Top Workplace for 12 consecutive years since the awards program began. It’s a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.
THE UCARE DIFFERENCE
The UCare difference is our people power – employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.
Company info
- Website
- https://www.ucare.org/about-us/careers
- Telephone
- 612-676-6500
- Location
-
500 Stinson Blvd.
Minneapolis
Minnesota
55413
US
You need to sign in or create an account to save a job.
Get job alerts
Create a job alert and receive personalized job recommendations straight to your inbox.
Create alert