Description

You will act as a subject matter expert for the Configuration workstream during large government implementations for Medicaid, Med/Surgical, and Medicare programs.

Responsibilities

• Perform data analysis and troubleshooting using configuration toolsets and automated processes.
• Build SQL queries to extract backend data and validate data by removing duplicates, errors, and outliers.
• Document requirements and process flows while executing testing for automation toolset enhancements.
• Provide Fit/Gap analysis and feedback assessments on new client plans.
• Collaborate with leadership on configuration roadmap deliverables to enable product and network automation.

Required Skills

• 5+ years of experience with the Facets platform.
• Experience in Medical Plan Benefit Configuration and Provider Network & Agreement Configuration.
• Proficiency in SQL and Oracle for data validation and backend data extraction.
• Strong understanding of Healthcare claims and benefit configuration.
• Knowledge of Medicare and Medicaid programs.
• Experience using Informatica and Facets for claims testing.
• Ability to manage and prioritize work to meet service level agreements and KPIs.
• Experience working with Windows applications.

Preferred Skills

• Strong analytical and problem-solving skills.

Key Skills

Education

Any Gradute