Insurance Jobs in Oregon with TN Sponsorship

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About Moda

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.

Position Summary

The CCA Configuration Analyst III is responsible for the analysis, design, and maintenance of the Clinical Care Advance system and other assigned systems, serving as a subject matter expert who identifies and resolves configuration issues, recommends improvements, and ensures high quality work. The role works closely with peers and management to troubleshoot system issues, support requirements and updates, and ensure interdepartmental needs are met, while also maintaining working knowledge of related enterprise systems such as Facets. The position provides recommendations for vendor system enhancements, tests delivered enhancements, and integrates them into ongoing configuration strategies. This is a FT WFH position.

Pay Range

$71,990.85 - $89,988.57 annually (depending on experience)

• This role may be classified as hourly (non-exempt) depending on the applicant's location. Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Benefits:

• Medical, Dental, Vision, Pharmacy, Life, & Disability
• 401K- Matching
• FSA
• Employee Assistance Program
• PTO and Company Paid Holidays

Required Skills, Experience & Education:

• Bachelor’s degree in business or healthcare related field. Equivalent education and experience may be considered.
• Minimum of 5 years of experience in a Systems Configuration, Claims, or Operations department within a healthcare organization.
• 2 to 5 years of experience working with clinical and care management systems such as the CareAdvance Enterprise Application.
• Working knowledge of enterprise systems such as Facets.
• Advanced knowledge of health plan configuration, including healthcare services, medical management, population health management, and industry care guidelines such as Milliman Care Guidelines.
• Knowledge of configuration change management methodologies, standards, and best practices.
• Experience with project management methodologies and the ability to manage projects and initiatives independently end to end.
• Proficiency in Microsoft Office products.
• Ability to understand business needs at both clinical and technical levels and translate them into configuration requirements.
• Ability to analyze processes, document workflows, perform gap analysis, and develop future state standardized workflows.
• Strong communication and meeting facilitation skills, with the ability to collaborate effectively with peers, management, and vendors.
• Strong analytical, organizational, and time management skills, with the ability to meet agreed upon timelines with accuracy.
• Ability to work well under pressure with constantly shifting priorities.
• Ability to maintain regular attendance, confidentiality, and a professional business image.

Primary Functions:

• Gather and document requirements, perform analysis, and develop configuration design to meet business needs.
• Manage complex system configuration and related documentation. Serve as a subject matter expert for configuration change management testing and best practices. Facilitate production controls and system configuration data codification.
• Monitor and review system edits and conduct advanced root cause analysis to identify issues and provide clear recommendations for resolution, including issues requiring multi-disciplinary technical skills.
• Identify and facilitate the implementation of process improvements and best practices.
• Interface and collaborate with peers and management throughout Healthcare Services and the organization to support configuration management best practices and system configuration life cycle management. Support project and program plans and tracking of configuration changes, operational issues, and resolutions.
• Represent the team on internal and external committees related to the system solution.
• Provide system-based recommendations regarding enhancement requests and the implementation of enhancement features.
• Lead and manage configuration project timelines to meet agreed upon deliverables.
• Coordinate the preparation and execution of test plans to validate that configuration updates and system fixes are complete and accurate and that enhancements function as designed.
• Perform other duties as assigned.

Working Conditions:

• Office environment with extensive close PC and keyboard use, constant sitting, and frequent phone communication. Must be able to navigate multiple computer screens. A reliable, high-speed, hard-wired internet connection required to support remote or hybrid work. Must be comfortable being on camera for virtual training and meetings. Work in excess of standard workweek, including evenings and occasional weekends, to meet business need.
• Internally with multiple departments. Externally with vendor and other health plans.

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. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our humanresources@modahealth.com email.