Job Description

Job Location: Smithfield, RI - Smithfield, RI 02917,

Position Type: Full Time, Education Level: Associates Degree,

Travel Percentage: None,

Job Shift: Daytime,

Job Category: Some Experience, The Configuration Quality Analyst is responsible for ensuring the accuracy, completeness, compliance, and quality of system configuration activities performed by the Configuration Services team. This position conducts detailed quality reviews and audits of configuration changes, validates testing and documentation, identifies trends and opportunities for process improvement, and ensures adherence to established standards, policies, and regulatory requirements.

This role serves as an independent quality resource by evaluating configuration deliverables, providing feedback and coaching, supporting root cause analysis efforts, and promoting continuous improvement across configuration processes. The position requires strong analytical and problem-solving skills, attention to detail, sound judgment, and the ability to collaborate effectively with cross-functional teams while maintaining objectivity and quality standards.

Duties and Responsibilities

The duties for this position include, but are not limited to the following items:

• Perform comprehensive quality reviews of configuration work completed by Configuration Team
• Audit configuration changes to ensure compliance with approved business requirements, technical specifications, organizational standards, and regulatory requirements.
• Review supporting documentation, test evidence, and change control records for completeness and accuracy.
• Validate benefit plan configuration, adjudication rules, and related configuration updates prior to production implementation.
• Evaluate unit testing results, positive and negative testing outcomes, and regression testing documentation for quality and completeness.
• Ensure Configuration Control Framework documentation is completed accurately and consistently.
• Verify production turnover packages and post-production validation activities meet established standards.
• Conduct periodic audits of configuration processes and deliverables to identify risks, gaps, and improvement opportunities.
• Develop, maintain, and report quality metrics, scorecards, trends, and key performance indicators.
• Identify opportunities to improve efficiency, consistency, and accuracy across configuration processes.
• Partner with Configuration Management Analysts, Business Analysts, and Testing teams to strengthen quality controls.
• Facilitate periodic reviews of standard operating procedures to ensure alignment with current business practices.
• Support annual audits of documented business processes and configuration procedures.
• Provide constructive feedback regarding audit findings and quality concerns.
• Partner with management to identify training and coaching opportunities.
• Serve as a subject matter expert regarding configuration quality standards and best practices.
• Assist in root cause analysis efforts involving configuration defects or production issues.
• Review configuration promotion activities for HealthRules, Burgess Source, and other applicable systems.
• Perform other duties as assigned.

Qualifications

Qualifications

Required

• Associate's degree and/or equivalent years of relevant work experience in lieu of a degree
• Minimum of two (2) years of experience in benefits and claims system configuration, quality assurance, auditing, business analysis, or healthcare operations
• Prior experience in a healthcare organization/setting
• Experience reviewing business requirements, test cases, configuration documentation, and system changes
• Strong analytical and problem-solving skills with exceptional attention to detail
• Excellent interpersonal skills, including the ability to work across the organization and interact, influence, and communicate effectively
• Ability to manage multiple priorities simultaneously in a deadline-driven environment
• Proficient in Microsoft Excel, PowerPoint, Word, and Project
• Strong verbal and written communication skills

Preferred

• Experience with HealthRules Payor transactional system
• Experience with JIRA
• Experience with SQL queries
• Experience with Source
• Experience developing quality metrics, audit programs, and performance reporting

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.