Configuration Analyst, Associate

Your Role

The Pricing Analytics and Contract Configuration team is responsible for configuring systems to pay per negotiated provider contracts. The Configuration Analyst, Associate will report to the Pricing Analytics Contract Configuration Manager. In this role you will conduct build activity, run test claims to ensure future claims will be paying correctly based on the contractual terms. You will validate that the negotiated provider contracts were built correctly and according to the contract’s specification. You will support process improvements by identifying possible gaps and addressing remediations.

Your Work

In this role, you will:

Analyze contract language to translate into specific pricing configuration with guidance

Develop simple configuration approaches to support solution selection and develop documentation outlining the approach using appropriate documentation protocols

Be accountable for the at least one contract type of configuration and testing of the assigned contracts

Develop and execute claims tests to support the testing terms and services for in the negotiated contracts

Work directly with Provider Contracting partners for clarifications when contract language may be unclear.

Analyze the provider contracts to ensure accuracy in the way it was built

Service (internal customers) with an oriented/philosophy and work in a diverse, demanding and evolving environment where strong analytical, problem-solving skills, time management and organizational skills are required

Other duties as assigned

Your Knowledge and Experience

Requires a bachelor’s degree or equivalent experience

0-2 years of prior relevant experience

Requires strong Claim’s knowledge and experience

Knowledge of FACETS, CLMS, MS Office Suite

Previous auditing experience and claims processing experience in a health plan

Service (internal customers) oriented/philosophy in a diverse, demanding and evolving environment with good analytical and problem-solving skills, time management and organizational skills

Excellent interpersonal skills and ability to act as a team player