Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.
The Test Analyst is responsible for pre- and post-production verification and validation of high risk, external facing configuration changes, identifying and reporting potential issues, defects, and process improvement opportunities. They will develop and maintain test cases, expected results, and execute testing to support validation of configuration activities within the SDLC, following Quality policies, procedures, and standards. This individual must have a strong understanding of health insurance payment (claims, capitation, or commissions) processing, member/group enrollment, id cards, billing, products, and analytical skills using tools such as MS Excel, MS Access, and Toad (SQL tool).

QUALIFICATIONS:

• Minimum of three (3) years healthcare insurance programs, processes, configuration and/or claims processing, IT, or customer service experience with specialization in benefits, enrollment, pricing, billing, or provider configuration.
• Associates degree or two (2) years of equivalent experience required.
• Minimum two (2) years’ experience working with relational databases and writing or modifying intermediate level SQL queries.
• Experience with Trizetto applications, such as Facets, is preferred.
• Three (3) years of overall QA and software testing experience with an understanding of functional, integration, system, and regression testing preferred.
• Two (2) years’ experience with a test management tool – such as QA Symphony or other tool, is preferred
• Experience working with ClaimsTest Pro, is preferred.
• Understanding of all types of health insurance enrollment, billing, and document management processing including, but not limited to, individual, group, governmental, and broker.
• Knowledge of healthcare and HMO processes, rules, regulations, enrollment/eligibility guidelines and reporting requirements for HMO, PPO, ASO, Medicare, Medicaid, Family Health Plus, and Child Health Plus, and provider payment methodologies.
• Strong analytical skills required.
• Ability to track, trend, and report useful data.
• Ability to understand Facets data model and Configuration tables related to benefits, pricing, ID cards, billing, claims, and provider data.
• Demonstrated ability to identify weaknesses in workflow and develop and implement process improvements to continually ensure that corporate goals are satisfied.
• Demonstrated ability to develop test plans, and test cases.
• Demonstrated experience in data access and relational databases using SQL, and working knowledge of Microsoft Access, Word, and Excel is preferred.
• Thorough knowledge of software development lifecycle(s) and software testing methodologies.
• Effective verbal, written communication & presentation skills are required. Must be able to communicate with technical and non-technical audiences.
• Excellent organizational, planning, time management, problem solving and decision-making skills including experience with risk assessment and root cause analysis required.
• Demonstrated experience in Microsoft Excel required.
• Experience developing complex test scripts a plus.
• Ability to think creatively and “outside of the box.”
• Ability to work independently as well as in a team setting is required.
• Able to work in fast paced environment.
  CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.
  CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits at https://www.cdphp.com/about-us/jobs/benefits.
  As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.
  CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC

Please refer the Job description for details