CareOregon · 13 hours ago
IS System Configuration Analyst II
United States
Full-time
Remote
Mid Level
$73K/yr - $89K/yr
3+ years expCareOregon is a managed care organization, and they are seeking an IS System Configuration Analyst II to provide system configuration for their managed care payment system and other core vendor systems. The role involves ensuring system configuration consistency, collaborating with various teams, and participating in vendor management to support organizational objectives.
Health Care
Responsibilities
Configure and perform daily software maintenance with some management oversight to support the efficient administration and data integrity of multiple systems:
QNXT, including claims, utilization management, benefits, contracts, member, call tracking, fees and code modules
Optum Claims Edit System
CareOregon Connect provider and member web portal
Participate in objective decision making to maintain data integrity, alignment and usability of applications for multiple departments across the organization in line with organizational objectives
Grow in identifying and articulating how the impact a configuration change has on upstream and downstream services and business workflows
Assist leadership in governance, demonstrating progress learning how to evaluate and monitor applications to ensure they align with and sustain the objectives of the organization
Participate in frontend and backend process testing and implementation of new software and software upgrades that supports the organization’s strategic goals
Perform advanced quality assurance testing to validate configuration behavior against established baselines, in keeping with contract, regulations, and customer requirements
Develop and maintain appropriate configuration documentation related to configuration and processes; participate in developing policies and procedures
Collaborate with business teams to build accurate system process and training documentation for consistency with system configuration and workflows
Collaborate with a variety of stakeholders with guidance from senior System Configuration Analysts or team manager
Serve as the point of escalation following the service desk for users experiencing software functionality issues
Assist operational departments with system functionality questions for current, new or emerging work
Assist users in submitting comprehensive development and Change Control Board requests
Assist software developers, production support, engineers and technicians with a variety of user, process and system needs, such as interpreting requirements for technical solutions and verifying deployed solutions meet the business need
Support internal and external auditors to provide system configuration information
Participate fully and constructively in department meetings, department decisions and department growth
Participate as an advance resource in interdepartmental workgroups, such as the Change Control Board, cost and utilization committees, and payment integrity program
Maintain impartiality and upholds the objectives of the organization
Participate in software user groups, attend conferences to further education and establish relationships with peer organizations
Conduct advanced research of software system enhancements and functionality
Participate in assessing impact of system changes on the organization and interfacing systems
Recommend software configuration that aligns with existing or new business requirements as identified by IS or operations teams
Review and interpret provider contracts for accuracy and assess ability to administer
Research and interpret CMS, OHA and federal and state regulations with manager guidance
Retain knowledge and remain abreast of relevant State and Federal laws and regulations relating to the medical health insurance industry and the Medicare and Medicaid industry
Consult with operational departments to determine needs and propose solutions in terms of system design and implementation
Research and advise users on best practices of system utilization
Identify situations where configuration alone cannot meet business requirements and participate with operational areas to develop supporting processes
Submit detailed, concise system functionality incidents to software vendors using their service software
Develop and maintain effective working relationship with vendors to communicate business needs, identify defects, and resolve system functionality gaps
Monitor reported issues and escalate serious issues or delays to management
Provision user security access for designated software applications following policies and procedures of CareOregon, vendor or business partners
Understand software usage and user’s position responsibilities sufficiently to identify when access is not in keeping with HIPAA minimum necessary protocol
Consult with manager regarding new and challenging access requests
Conduct regular audits of user security audits
Perform work in alignment with the organization’s mission, vision and values
Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals
Strive to meet annual business goals in support of the organization’s strategic goals
Adhere to the organization’s policies, procedures and other relevant compliance needs
Perform other duties as needed
Qualification
Required
Minimum 3 years' experience in system configuration or progressively responsible experience in areas that integrate with configurations such as claims processing, coding, auditing, billing, or encounter data
Advanced knowledge in some or all of the following areas: Computer applications skills (claims payment, Excel, Word, Outlook), Computer programming concepts and practices, Medicaid and Medicare benefit plans, ICD, CPT, HCPCS and other national coding systems, Claims operation practices and protocols, Principles and practices of managed care systems, procedures, and plan products/systems, System plan/benefit building and maintenance, HIPAA regulations and compliance, Computing/applying rate calculations, and resolving rate calculation disputes
Effective communication skills, including listening, verbal, written, and customer service
Ability to clearly articulate policies and instructions
Ability to exercise professionalism
Effective ability to network and utilize internal and external resources
Ability to convey appropriate level of detail to all levels of the organization including non-technical staff
Growing ability in simplifying and presenting complex concepts in an easily understood way
Ability to proactively and appropriately communicate status and needs
Ability to recommend policies, document risks, and propose solutions to information services management and senior leadership
Possess a high degree of initiative and motivation
Ability to lead teams of people with some oversight
Effective project management skills
Effective vendor management skills
Ability to produce high quality and timely results, with effective organizational skills
Effective analytical and research skills; demonstrated progress in seeing patterns in data and drawing appropriate conclusions
Basic creativity and innovation abilities
Ability to propose solutions and communicate business value
Preferred
2 years' experience in claims processing, coding, or auditing
1 year experience in health plan system (e.g., QNXT, Facets, Tapestry, etc.) or provider revenue system
Benefits
Medical
Dental
Vision
Life
AD&D
Disability insurance
Health savings account
Flexible spending account(s)
Lifestyle spending account
Employee assistance program
Wellness program
Discounts
Multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.)
Strong retirement plan with employer contributions
PTO
Paid State Sick Time
Paid holidays
Volunteer time
Jury duty
Bereavement leave
Company
CareOregon
Everyone deserves great health care.
501-1000 employees
H1B Sponsorship
CareOregon has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (10)
2023 (3)
2022 (6)
2021 (3)
2020 (2)
Funding
Current Stage
Late StageLeadership Team
Eric C. Hunter
President and Chief Executive Officer
Amy Dowd
COO
Recent News
Behavioral Health Business
2025-09-13
2025-08-29
oregonlive.com
2025-08-13
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