Senior Provider Configuration Analyst

Job Ref: TE0123
Category: Information Technology
Department: INFORMATION TECHNOLOGY
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Work Arrangement: Remote
Salary Range: $105,000.00 - $115,000.00

The Senior Provider Configuration Analyst will be responsible for the configuration of MetroPlusHealth’s systems to ensure that claims are processed according to Provider contracts.

Scope of Role & Responsibilities

• Configure provider reimbursement and create and maintain fee schedules.
• Analyze departmental requirements needed to develop long and short-term plans.
• Ensure system processes and services are aligned with the needs of the department.
• Analyze the system to ensure claims are processed correctly to protect the company from liabilities.
• Collaborate with MetroPlusHealth’s system consultants to correct errors, rectify omissions, and investigate system issues.
• Identify potential system problems for claims resolution.
• Review test cases to ensure they are in accordance with requirements and assist with overall testing processes.
• Conduct ongoing reviews of systems and processes to ensure accurate and optimum setup for both provider and claims.
• Receive, coordinate, and manage requests for Systems Modifications.
• Maintain and track open issues and coordinate release testing.
• Assist with the system migration to HealthEdge HRP and Source products.
• Run reports and perform analysis using SQL.
• Create and maintain an inventory of pricing templates and their contents
• Monitor and Manage Core Systems performance
• Respond to escalated issues from various MetroPlusHealth Departments.
• Perform and assist with any other functions as required by the Director of Provider Contract Configuration
• Participate in special projects and strategic initiatives as needed.

Required Education, Training & Professional Experience

• A Baccalaureate Degree from an accredited college or university required, Computer Science preferred; and
• Six (6) years of progressive, responsible experience in configuration for data processing, computer systems and applications;
• Experience with HealthEdge HRP and Source products required.
• Demonstrated experience supporting system configuration, workflow analysis, and technical documentation in a healthcare or claims environment.

Professional Compentencies

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication
• Ability to work independently, manage multiple priorities, and maintain attention to detail.