Payer Configuration Analyst

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $100k - $120k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

🧐 Analyst

🚫👨‍🎓 No degree required

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HealthEdge

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2005

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

📋 Description

• Serve as a functional lead assigned to an implementation • Analyze business requirements • Configure and unit test HealthRules Payor software • Provide configuration requirements to offshore teams • Monitor implementation progress to ensure delivery on time and alignment with project objectives • Identify risks and develop mitigation strategies as needed • Independently solve and test complex scenarios • Analyze data and draw conclusions • Understand and execute automation tools • Assist team members with complex issues related to areas of expertise • Work in a team environment and share knowledge • Work across multiple time zones using video technology • Find and document root causes and communicate possible resolutions

🎯 Requirements

• Minimum high school diploma required • Professional degree preferred • Minimum 2 years of HealthRules Configuration Experience • Three-plus years of experience/knowledge of HealthRules Payor, a claims processing system • Experience working in an offshore model required • Proficiency with Microsoft Word, PowerPoint, Excel, and Visio • Experience with Agile tools and methodologies, including JIRA and SCRUM • Analytical abilities • Critical thinking • Leadership ability • Familiarity with debugging and testing concepts • Ability to communicate effectively across Technology, Business, and Operations • Ability to work across multiple time zones in a hybrid or remote work environment • Candidates may be required to complete a pre-employment criminal background check

🏖️ Benefits

• Annual US base salary range of $100,000 to $120,000 • Remote work environment • Hybrid or remote work environment • May require travel dependent on company needs • Reasonable accommodations for individuals with disabilities in compliance with the Americans with Disabilities Act • Equal opportunity employer committed to workforce diversity