Configuration Analyst

Healthcare Expert

A. Healthcare expert with more than 8 years of experience in the US healthcare payer industry

B. Experience with FACETS core administrative platform and having worked on provider agreements configuration in NetworX

C. Interpret provider contracts and translate to agreement in NetworX

D. Analyze requests, determine best operational approach to perform contract/agreement configuration

E. Provide direction to the team on building rate sheets/fee schedules/qualifier groups

F. Need to provide SME support and clarify questions to the customer for the topics pertaining to agreement configuration

G. Take part in contract configuration design related discussions with client team and provide suggestions

H. Working and troubleshooting claims that suspend for lack of contracts or provider configuration issues in Facets

I. Strong SQL skills and good understanding on the Facets data model

J. Monitor functional specifications and change requests to ensure project stays within scope and meets regulatory requirements

K. Ability to lead team for respective business entities as needed and develop procedures, service standards for business excellence

L. Should be a self-driven person possess strong interaction skills with business users of customer

Must Have Skills: Facets – NetworX, Facets – Claims

Experience: 5+ yrs in Facets

Required Skills: Facets - Benefits, Hierarchy, Billing, and Pricing. NetworX. Strong SQL skills

Nice to have skills: Facets - Configuration, Workflow

Technology: Not Applicable

Shift: Day

Roles & Responsibilities: To lead the configuration work for BAU / implementations as appropriately

Job Location Primary: USPAJEUC01 Jessup - PA USA, CLT Alternate:

Job Type: 50CW00 Business Associate

Demand Requires Travel? N

Years of Experience: 9.00