Configuration Analyst

Your Role The QC Pricing Analytics and Contract Configuration team is responsible for performing an in-line audit for all negotiated provider contracts. The QC Configuration Analyst Associate will report to the QC Pricing Analytics Contract Configuration Manager. In this role, you will conduct audits and run test claims to ensure future claims will be paid correctly based on the contractual terms. Validate that the negotiated provider contracts were built correctly and according to the contract's specification. Support process improvements by identifying possible gaps and addressing remediations. Your Knowledge and Experience Requires a bachelor's degree or equivalent experience 0-2 years of prior relevant experience 0-2 years of prior audit experience of auditing BSC contracts Requires strong medical claims 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 Hybrid This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week. Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need. #J-18808-Ljbffr