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Configuration Solutions Architect

Position Summary The Configuration Solutions Architect is responsible for the overall direction, coordination, implementation, execution, control and completion of new and existing client implementations. Additionally, this role will serve as a Configuration Services Subject Matter Expert (SME) and is expected to support issue resolution, new program assimilations, and research response, and provide guidance. Essential Duties and Responsibilities include the following. Other duties may be assigned. Serves as implementation lead for design and configuration processes, for all implementations including benefit plan design, formulary coding options and pharmacy network configuration solutions Participates in technical design reviews and gathers and documents client requirements and business specifications for implementation projects and programs Champions best practices and the use of standardized methodology to document requirements and ensures that appropriate rationale exists for non-standard designs and that all efforts are undertaken to prevent inefficient and non-sustainable configuration structures Maintains an in-depth working knowledge of the MedAccess processing system and ensures up-to-date documentation of adjudication hierarchies, edits, restrictions, tables, carriers, and other configuration components in order to provide technical direction and best practice recommendations for the set-up of client benefit, formulary and network designs Evaluates and develops POS edit enhancement logic to ensure proposed design satisfies the intended solution for claims adjudication when system constraints arise Partners with quality assurance team to support end-to-end testing of design configurations. Promotes continuous improvement by ensuring adherence to quality principles.Seeks out and actively participates in business initiatives that contribute to service excellence. Reviews and approves design plans for complex and unique configuration requests Maintains a collaborative relationship with each client, participating in regularly scheduled implementation calls to understand client business objectives and gather design requirements Participates in the external test claim review process, and supports the implementation and client teams in obtaining sign off of results prior to move to production, and ensures that configuration changes meet client expectations for accuracy Works with the assigned Configuration Analysts to explain the configuration set-up during transition from implementation to maintenance of business Leads annual configuration review with clients, providing an overview of their benefit structures and linkages, highlighting changes during the review period and communicates recommendations for improvement Collaborates and cultivates positive relationships with internal and external customers through delivery of sustainable, measurable, accurate, reliable, and timely results that meet or exceed customer expectations.Promptly responds to service failures, resolves issues, and escalates concerns as appropriate Utilizes project planning, prioritizing, and organizational skills to ensure timely deliverables, high levels of quality, and efficient use of resources to achieve claims adjudication accuracy Ensures appropriate back up coverage for customers during holidays, weekends, and other times Leverages Salesforce as the enterprise customer relationship management tool for documenting all client contacts and deliverables requiring follow-up Oversees assigned cases and ensures adherence to business rules and due dates Completes special projects and assignments, and participates as a key member of cross functional workgroups, teams, and committees as assigned Confidently interact with clients and internal cross-functional teams to ensure implementation project timelines are on schedule Stay current with Medicare Part D and other guidelines in order to assess changes in configurations to ensure compliance with Federal and State rules and regulations. Supports new product offerings and strategic marketing efforts. May participate in Best and Final Presentations and/or Implementation Kick-off meetings as a Subject Matter Expert (SME), inclusive of travel Education and/or Experience For consideration, candidates will need a Bachelor's degree (B.A.) from four-year college or university or a minimum of four (4) years job related experience and/or training, two (2) of which should be for configuration and design in Pharmacy Benefit Management; or equivalent combination of education and experience. Candidates will also need experience in designing and leading new and existing client implementations.   Project management experience is required.  Business systems analysis experience is preferred.  Computer Skills Intermediate to advanced knowledge of MS Office / Word, Excel PowerPoint, and Outlook Experience as an advanced user of multiple business software applications and working knowledge of key technical applications such as SQL, Oracle based platforms, and Golden 32 The ability to run SQL queries and scripts is helpful   315.181213.5934/HPP
Salary Range: NA
Minimum Qualification
Less than 5 years

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