Operations Configuration and Integration Analyst

Job not on LinkedIn

🔥 12 hours ago

🗽 New York – Remote

🗽 New York – Remote

💵 $27 - $48 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

⚙️ Operations

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Create, update, test and maintain system configuration tables and files supporting accurate claims adjudication • Analyze, interpret, load, test and maintain configurable tables, files and software for claim adjudication • Assist in developing and executing testing scenarios and test conditions • Perform unit and/or end user testing for new configurations, programming enhancements, benefit designs, provider contracts and software changes • Identify opportunities and recommend system solutions to increase automation, resolve system deficiencies and enhance claims processing • Monitor company business strategies and marketplace trends to support future business needs • Research and resolve configuration-related claim problems or issues • Develop system queries to determine problem scope and recommend solutions to management • Serve as a technical reference for translating system specifications and operations • Coordinate system programming changes and schedules with IS Business Analysts and Programmers • Maintain comprehensive knowledge of claims adjudication rules, MC400 editing, claim processing programs, Macess imaging and related software • Perform other assigned duties

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Bachelor’s Degree or an equivalent combination of education and experience in a managed care environment • Minimum two to three years experience in an automated medical claims environment and managed care/multiple product environment desired • Minimum one to two years experience in systems logic and testing desired • Knowledge of claims adjudication rules, MC400 editing and claim processing programs, Macess imaging system and claim-related software packages • Knowledge of configurable tables, files and software supporting claims adjudication • Experience with testing scenarios, test conditions, unit testing and/or end user testing • Experience developing system queries • Must comply with all policies and standards

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plan • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation