Think Beyond The Label Jobs

The Configuration Management Senior Business Analyst serves as a lead representative/Subject Matter Expert for the PRISM Benefits Administration subsystem in addition to other business areas of PRISM. Analyze,research,and make recommendations to policy staff on new and existing procedure and ICD-10 codes. Communicate and work with appropriate Utah Medicaid staff to resolve complex claim denials.  Ensure program quality and data integrity to align with Federal,State,and Department requirements.

Responsibilities Include

• Developing and maintaining configuration testing and release plans on a functional and systems level.

• Developing system/edit changes by analyzing the more complex discrepancies between the PRISM reference data and paid claims information with policy intent.

• Tracking quality improvement initiatives.

• Reviewing system documentation and standard operating procedures to ensure compliance with procedures,regulations and standards.

• Coordinating and participating in operational releases.

• Performing activities which may include: the utilization of SharePoint and other computer software programs to store data,retrieve stored data,analyze retrieved data,and arrange results in a format that effectively supports Medicaid s production activities; and help identify better ways to utilize the system's capabilities.

• Monitoring CMS and other health care carriers coverage information and program policies,along with industry standards and practices,as they relate to the Medicaid program.

Preferred Qualifications

• At least 2 years of certified medical coding and billing experience,or at least 2 years of experience in data analytics and software testing.

• Familiar with industry-standard testing practices and writing test plans.

• Experience with CPT,HCPCS,ICD-10 coding

• Ability to conduct detailed research of intended subject matter according to Division needs

• Strong interpersonal,communication,and presentation skills

• Certified medical coder

Note: as of April 8,2024,DHHS employees will be working a hybrid schedule,which includes 2 office days per week and 3 telework days.     Why work for the Utah Department of Health and Human Services?  In addition to the rich benefits  the State of Utah offers,the department offers:

• On-site fitness center,for a minimal membership fee
• UTA Eco Pass,at a discounted monthly rate
• Teleworking opportunities with a minimum 2 office days per week beginning 04/2024.
• On-site day care center at the Cannon Health Building with First Steps Day Care - contact for rates and availability,801-538-6996

For more information on the Utah Department of Health and Human Services,please click here.                                                                                 If offered this position,your employment will be contingent upon passing a background check and review.  There will be no cost to you for this check.  This check will include fingerprinting,which will be available at various DHHS locations for your convenience. Fingerprinting will be completed prior to your first day of employment.  You may review the policy by clicking here.{target="_blank"}