13 days old
2018-05-102018-06-07
  • Job Code
    619976
  • Payrate
    $40 To $50

We are looking for a responsible individual that will provide support for a wide range of projects. The candidate will work with Developers, System Administrators, and business areas to develop solutions to business and system needs. Our Business Analyst will work with industry leading systems as they support the rapidly changing demands in the Healthcare industry.


Duties:










  • Create and maintain Facets benefit components for new and renewing for Medical group as well as updating and maintaining all documentation related to changes.
  • Participates in meetings representing Benefit Configuration Administration to fully understand plan benefits and validate Facets capabilities.
  • Ensures benefit configuration turnaround times are met for all request. Lead on inquiries from Claims, Professional Relations and Business Units regarding contract and product set-up issues on all products.
  • Performs testing on claims to validate benefit configuration will meet the needs of the Claims department.
  • Assists with department projects and reports at the direction of department management Interprets benefit information from the group application and or contract language in order to create a product within corporate turnaround time standards.
  • Documents departmental policies and business processes as assigned by department management.
  • Lead contact for configuration in any of the following areas: claims, subscriber family, clinical editing, and utilization management
  • Performs other duties as assigned



Skills:






Preferred Qualifications:



  • Must have ability to exercise independent judgment in planning, organizing, and performing systems analyst tasks.
  • Knowledge with TriZetto Facets.
  • Knowledge with Optum products; CES, PPS, and Optum pricing systems.
  • EDI X12 Background a plus.



Experience with Benefit and Pricing Configuration and knowledge of Provider Contracting.


Excellent interpersonal and leadership skills including the ability to work with both internal and external customers and all levels of the organization.


Excellent organizational skills with the ability to handle multiple projects and timelines with minimal supervision.


Problem solving and conflict management skills including the ability to manage conflict and find mutually acceptable resolutions.


Both a strategic and tactical mindset to enable the development of a general high level design and to enable detail reviews of Technical Detail Designs.


Education:

Bachelors degree in Computer Science or a related discipline, at least four, typically six years of solid, diverse work experience in IT.




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Business Analyst

Randstad Technologies
Miami, FL 33166

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Randstad Technologies
Miami, FL
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