Job Summary: We are seeking a highly skilled and experienced Configuration Analyst to join our team. The ideal candidate will have extensive knowledge of Healthcare Payer operations and a strong experience in developing and delivering configuration on Claims platforms like Core Admin platforms. This role is essential for ensuring that our staff are well-trained and knowledgeable about industry standards, processes, and best practices.
Configuration Analyst
Location: Any Location (WFH)
Shift Time - Night Shift
- Duties and Responsibilities:
- Configuration of Healthcare Payer (Health Plan) Core Administrative Platforms:
- Design and Configure the benefits, system parameters, and pricing requirements on the Health Plan (Payer) core administrative platforms for various lines of business, including Medicare, Medicaid, Commercial, and Individual-Exchange, ensuring compliance with business requirements and regulatory standards.
- Requirements Gathering and Analysis:
- Collaborate with clients and internal stakeholders to gather and document configuration requirements, ensuring a clear understanding of client needs and project objectives.
- Configuration Design and Execution:
- Develop detailed configuration designs, incorporating feedback from clients and internal stakeholders, and obtain approval prior to implementation.
- Execute configuration activities as per the approved design, ensuring accuracy and alignment with client specifications.
- Testing and Quality Assurance:
- Partner with the testing team to conduct thorough testing of configurations, review results, and make necessary adjustments to ensure quality and performance standards are met.
- Minimum Required Skills and Qualifications:
- Minimum of 2+ years of experience in Configuration on either HealthRules Payer or Facets or QNXT is required (US Health insurance).
- Proven experience with configuration for Medicare, Medicaid, Commercial, and Individual-Exchange lines of business.
- Experience with HealthEdge HealthRules Payer (HRP) configuration would be preferred
- Experience with HealthEdge Source (Burgess) or HealthEdge GuidingCare would be added advantage
- Strong communication skills, with demonstrated ability to engage effectively with clients and internal stakeholders.
