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Corporate Functions & Operations WellCare - Data Analyst Careers

Configuration Analyst Job

Full Job Title: Configuration Analyst

Job Number: 1802379

Location: Tampa, FL

Date Posted: 5-25-2018

Location: W Idlewild Ave, Tampa, FL 33634
Department: Operations - Institutional Configuration
Reports to: Manager, Configuration

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

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: High School or GED
Candidate Experience:
  • Required: 3 years of experience in analytics in a related field
  • Preferred: 1 years of healthcare experience
Candidate Skills:
  • Knowledge of Claims Processing
  • Advanced understanding of contract terms and how they are loaded into the system
  • Advanced knowledge of provider/institutional billing practices
  • Ability to effectively research issues and resolve problems
Technical Skills:
  • Peradigm (Diamond)
  • SAS or SQL
  • Cactus systems
  • Knowledge of CPT/HCPCS coding

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Last Updated On: 12/9/2015