Configuration Analyst – HealthRules

The Configuration Analyst is responsible for all tasks related to configuration and maintenance of the business rules within the ecosystem, including HealthRules, iCES, 3MDRG, Care Manager, HPExtrem and others. The incumbent possesses a high degree of expertise in the configuration of business rules that support reimbursement policies and methodologies, member/provider contracts, and correspondence. The incumbent plays a key role in the configuration and implementation of new markets and products.

The Configuration Analyst identifies, researches, and resolves inaccuracies and inconsistencies in the system as they impact claims payment and other upstream and downstream transactions and processes.

Qualifications:

• Bachelor’s degree or equivalent technical skills and experience
• Major: Business Administration, Health Care or Information Technology
• 2+ years prior experience implementing and configuring health plan core administration systems (e.g. Facets, QNXT, Trizetto, MetaVance, Health Rules, IKAsystems, Amisys, COSMOS, UNET, iCES, 3MDRG, HPExtrem).

Specific Types of Experience or Skills Required:

• Institutional and Professional Claims processing knowledge
• Coding knowledge and experience with CPT, HCPCS, ICD9, ICD10, Revenue, DRG and other relevant medical and industry-standard codes
• Demonstrated configuration knowledge and experience
• Healthcare experience
• Demonstrated competence in Microsoft Office
• Demonstrated ability to meet deadlines
• Strong commitment to quality and service
• Strong written and verbal communication skills
• Able to prioritize and execute tasks in a fast-paced environment
• Self-starter with the ability to self-manage work loads
• Able to work well in a team-based, collaborative environment

Travel: 5%

Equal Opportunity Employer Including Veterans & Disabled Individuals