Blue Shield Of California

Platform Administrator, Consultant

Blue Shield Of California$90K — $120K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience required
  • Minimum of 7 years of relevant experience required
  • At least 7 years in complex business analysis and/or technology healthcare operations needed
  • Minimum of 3 years in a team leadership or mentoring role required
  • Preferred knowledge of EDI 270/271 configuration and claim processing rules
  • At least 5 years in a configuration analyst role configuring health plan business applications preferred

Responsibilities

  • Analyze complex business requirements and vendor software objectives
  • Provide input in cross-functional sessions to propose platform solutions
  • Ensure solution traceability to performance goals and metrics
  • Oversee end-to-end business solutions and platform configuration
  • Review and approve configuration analysis, design, coding, and testing
  • Manage configuration quality assurance for complex solutions
  • Facilitate escalation issue resolution with the configuration vendor
  • Lead troubleshooting and root cause analysis with stakeholder communication
  • Act as liaison between IT and business areas
  • Identify process improvements and automation opportunities for configuration builds
  • Demonstrate effective communication with business and IT leaders

Benefits

  • Hybrid work model with flexibility and in-office collaboration
  • Opportunity to influence process improvements and automation
  • Engagement with cross-functional teams to assess and implement solutions
Full Job Description
Job Description

Your Role

The Business Configuration Oversight team is responsible for Overseeing Configuration and delivery of Projects by vendor. The Platform Administrator, Consultant will report to the IT Development Manager. In this role you will also provide Facets application domain expertise, story refinement, design approvals and act as liaison between IT and business areas.

Responsibilities

Your Work

In this role, you will:
  • Analyze complex business requirements and software/product objectives to perform Oversight of the Configuration vendor
  • Provide input in cross-functional work sessions to assess requirements and propose out-of-the-box platform solution options
  • Ensure traceability of solutions back to performance goals and metrics
  • Be responsible for end-to-end business solutions, including all areas of platform configuration and working with IT partners on interfaces, extracts or extensions, following established processes, standards and procedures (with manager oversight)
  • Review and approve system configuration analysis, design, coding, and unit testing following established processes, standards, and procedures
  • Be responsible for configuration and quality assurance of low to highly complex solutions using best practice and low-code platform configuration
  • Facilitate resolution of escalated issues in the appropriate manner with appropriate timeframe by Configuration Vendor. Ensure traceability of solutions back to performance goals and metrics.
  • Lead troubleshooting and root cause analysis, including meeting SLAs and stakeholder communication
  • Act as the liaison between IT and business areas in support of extensions and service packs
  • Work with team to identify process improvements and automation opportunities to improve quality and timeliness of configuration builds
  • Be proficient with Facets Configuration with emphasis on Product Config and Shared Advantage line of business
  • Be proficient in SQL scripts and Facets Data Model and should be able to write complex queries to pull Facets backend data
  • Demonstrate effective communication with other business leaders and IT leaders regarding configuration capabilities


Qualifications

Your Knowledge and Experience
  • Requires a bachelor's degree or equivalent experience
  • Requires a minimum of 7 years of prior relevant experience
  • Requires at least 7 years performing complex business analysis and/or technology healthcare operations
  • Requires at least 3 years of experience in leading and mentoring the team
  • Preferred knowledge of EDI 270/271 configuration, transaction rules and Claim Processing Rules (Procedure and Diagnosis Codes)
  • Preferred at least 5 years of experience in a configuration analyst role, configuring health plan business applications


Hybrid

This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.

About Blue Shield Of California

Blue Shield of California is a not-for-profit health plan provider that has been providing Californians with access to high-quality healthcare for over 80 years. The company offers a range of health insurance products and services to individuals, families, and employers. Blue Shield of California is committed to improving the health and wellbeing of its members and the communities it serves. The company is also committed to sustainability and has implemented a number of initiatives to reduce its environmental impact.
Learn more about Blue Shield Of California
Size
7,000 employees
Industry
Founded
1981

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