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Corporate Functions & Operations WellCare - Data Analyst Careers

Configuration Analyst Job

Full Job Title: Configuration Analyst

Job Number: 1703158

Location: Phoenix, AZ

Date Posted: 7-13-2017

This position is forCare1st Health Plan in Phoenix, a Wellcare Healthplans, Inc. company.

Oversees accurate and timely development of price rules and contract templates. Develops new business plans that will help promote technology and automation.

Department:Provider Operations
Reports to: Sr Mgr, Operations
Location: Camelback Rd, Phoenix AZ 85016
Job Type: Salaried/Exempt

Essential Functions:
  • Builds rules within the Peradigm System, in coordination within State and Federal guidelines.
  • Monitors and tests the accuracy of price rules.
  • Researches both State and Federal mandates and builds interpretation grids.
  • Builds and tests contracts and pricing templates for the non-par and new business teams.
  • Works with all regions on non-par documentation.
  • Trains/monitors staff on contract pricing and contract templates.
  • Resolves provider load issues within appropriate time.
  • Ensures proper supporting documentation and maintains files for all price rules.
  • Resolves critical errors forwarded from the claims department.
  • Builds and maintains positive business relationships with business partners.
  • Loads professional contracts into the Diamond System through appropriate research and provider data load activities.
Candidate Education:
  • Required A High School or GED
Candidate Experience:
  • Required 3 years of experience in analytics in a related field
  • Preferred prior healthcare experience
Candidate Skills:
  • Advanced understanding of contract terms and how they are loaded into the system
  • Advanced knowledge of provider/institutional billing practices
  • Advanced ability to effectively research issues and resolve problems
  • Intermediate knowledge of Claims Processing
Technical Skills:
  • Required Intermediate Microsoft Outlook
  • Required Intermediate Microsoft Excel
  • Required Beginner Access
  • Required Intermediate Peradigm (Diamond)
  • Preferred claim payment software experience

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Last Updated On: 12/9/2015