Sr. Configuration Analyst-HealthRules

Sr. Configuration Analyst-HealthRules

16 Jun 2024
Minnesota, Mpls, 55413 Mpls USA

Sr. Configuration Analyst-HealthRules

Vacancy expired!

Job Description

At NTT DATA Services, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA Services and for the people who work here.

Senior Configuration Analyst - HealthRules

(Temporary - 6-8 month assignment)

Position Description

This position is responsible to design, configure, test, implement and maintain HealthRules Payor pricing, claims and/or benefit configuration, according to business requirements, to support accurate and efficient claims processing and data reporting. Investigate and resolve configuration-related provider, member and claim processing issues and assist other departments in understanding HealthRules Payor configuration. Lead complex configuration projects, annual readiness configuration and care system contract implementations.

Responsibilities
  • Develop and maintain an understanding of current HealthRules Payor configuration, contracts, products, and policies.

  • Analyze, configure, test, implement and maintain HealthRules Payor to support changes in contracts, products, legislation, and policies and procedures, ensuring timely maintenance and updates of configuration.

  • Test, implement, and train on new HealthRules Payor and third party product releases, modules and updates.

  • Assist in the development of test scenarios for changes and/or projects.

  • Manage the timely resolution of open testing bugs and issues.

  • Develop and monitor postproduction audit reports to ensure the intent of change and/or project requirements is being met.

  • Develop and maintain configuration documentation and communicate changes, as appropriate.

  • Work with Technical Business Analyst, UAT and QA to create detailed functional requirements that support and align to business requirements and testing scenarios.

  • Research and respond to service requests in a prompt and timely manner and update or build configuration in HealthRules Payor as needed.

  • Recommend and draft new and updated procedures to maximize the use of HealthRules Payor and other third-party products to improve efficiency.

  • Develop and maintain good working relationships with the staff of other departments including Provider Relations & Contracting, Healthcare Economics, Provider Assistance Center, Government Relations, Product, and Coverage Policy.

  • Inform leader and peers of changes that will impact the company.

  • Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner. Other projects and duties as assigned.


Basic Qualification

  • Five years of configuration experience or a combination of claims processing, healthcare system operations, data analytics and configuration.

  • 2+ years' experience with HealthRules

  • Must possess working knowledge of managed care operations, system development and testing.

  • Microsoft Office proficiency.


Preferred Experience

  • Experience using Business Objects.

  • Ability to build and maintain relationships across the enterprise.

  • Strong knowledge of government programs, regulations, and benefits.

  • Previous experience with CMS, Client or payer reimbursement methodologies and /or payment policies. Knowledge of or experience with Optum Claims Editing System (CES) and Axiom TranSend.


Education

Bachelor's Degree in Business or Healthcare is preferred. Demonstrated work experience may be considered in lieu of degree.

To qualify, applicants must be legally authorized to work in the United States, and should not require, now or in the future, sponsorship for employment visa status. No C to C

About NTT DATA Services

NTT DATA Services partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.

NTT DATA Services, headquartered in Plano, Texas, is a division of NTT DATA Corporation, a top 10 global business and IT services provider with 118,000+ professionals in more than 50 countries, and NTT Group, a partner to 88 percent of the Fortune 100. Visit nttdataservices.com to learn more.

NTT DATA, Inc. (the "Company") is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.

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