Moda Health Lead Benefit Configuration Analyst in Portland, Oregon
Lead Benefit Configuration Analyst
Lead Benefit Configuration Analyst
Open Until Filled
Job Class: 213.0
Let’s do great things, together
Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.
Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.
Moda Health is seeking a Lead Benefit Configuration Analyst. This position is provide back-up for all supervisory responsibilities and assists the supervisor in monitoring unit performance relative to key objectives; provides on-going technical support and training for unit; responsible for sensitive group benefit configuration issues and questions. Analyzes system solutions, defines and builds benefit designs, and maintains configuration within the systems; assist in managing the volume of work and direct team resources to ensure turnaround times are met.
Primary Functions:01. Analyzes and evaluates requirements determine the most effective and efficient configuration to achieve the highest possible quality and auto-adjudication.02. Participates in meetings representing Configuration team in order to fully understand plan benefits and validate programming capabilities.03. Understands/implements changes with broader knowledge of problematic issues. Views Facets with larger impact in mind and downstream effects.04. Answers all inquiries from various departments regarding contract and product set up issues for all lines of business.05. Responds to questions with the desire to provide education and obtain additional understanding of the request, situation, or business need.06. Responds using root-cause analysis for other departments and upper management.07. Evaluates and resolves configuration questions and communicates product updates and changes to team and various departments.08. Reviews configuration changes for accuracy prior to migration to production.09. Must be an excellent team member with a true commitment to provide the highest quality configuration solutions to a customer.10. Ensures benefit configuration turnaround times are met for all new and renewing groups. 11. Understands issues and provides new ideas for smoother process and controls which are implemented for quicker turnaround times.12. Identifies situations where benefit configuration alone cannot fully meet the plan’s requirements. Works with departmental management, and cross functionally, to identify the Workflow configuration and associated business processes needed.13. Provides training to new staff as well as ongoing training for current staff.14. Develops and maintains configuration documentation for each line of business which will include all configuration rules and guidelines to be used by entire configuration team.15. Supports quality and process improvement initiatives.16. Provide backup for supervisory duties, displaying a model of leadership to the department, while guiding and developing Benefit Configuration Analysts. 17. Performs other duties as assigned.
Are you ready to be a betterist?
If you’re ready to make a difference that matters, we want to hear from you. Because it’s time to discover what’s possible.
Together, we can be more. We can be better.
Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
Bachelor’s degree or equivalent work experience.
3 + years prior Healthcare/Insurance experience is required, with a preference for those with experience building benefits in Facets or other systems.
PC proficient with good working knowledge of Microsoft Word, Excel, and Access (SQL).
Displays excellent leadership skills. Previous leadership experience is preferred.
Ability to train others and present information in a well thought out and easily understood manner.
Ability to instruct, motivate and mentor staff as individuals and as a team at various skill levels, face to face and in a classroom setting.
Strong analytical, problem solving, decision making, organizational, and detail oriented skills.
Proven facilitation and conflict resolution skills.
Ability to lead and facilitate meetings as needed.
Demonstrated ability to meet or exceed quality expectations on a consistent basis.
Strong verbal, written, and interpersonal communication skills and ability to interact professionally, patiently, and in a positive manner with internal and external customers.
Ability to work well under pressure with frequent interruptions and shifting priorities while demonstrating professional leadership qualities.
Ability to audit product configuration with a high degree of accuracy, and within established timelines.
Ability to work independently, with minimal supervision.
Maintain confidentiality and project a professional business image.
Ability to come in to work on time and on a daily basis.