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Corporate Functions & Operations WellCare - Data Analyst Careers

Configuration Analyst - Senior Job

Full Job Title: Configuration Analyst, Sr

Job Number: 1701913

Location: Tampa, FL

Date Posted: 5-15-2017

The Senior Configuration Analyst is responsible for accurate and timely development of automated rules and pricing. This position will also need to help develop 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, fee schedules, contract loads as assigned
  • 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
  • Trains/monitors staff on contract pricing and contract templates
  • Ensures proper supporting documentation and maintains files for all price rules
  • Maintains all automated reports for assigned areas.
  • Builds and maintains positive business relationships with business partners
  • Loads contracts/fee schedules into the Peradigm System through appropriate research and provider data load activities
  • Monitor and develop automated provider loads into the Peradigm
  • Monitor and develop automated batch claims processing.
  • Works with management to identify, develop, and implement tools, applications, and reports focused on increased automation, improved load quality, and input/ throughput/output measurement.
Additional Responsibilities:Candidate Education:
  • Required A High School or GED
  • Preferred A Bachelor's Degree in a related field
Candidate Experience:
  • Required 4 years of experience in analytics or related field
Candidate Skills:
  • Intermediate Other Knowledge of Claims Processing
  • Advanced Other Understanding of contract terms and how they are loaded into the system
  • Advanced Other Knowledge of provider/institutional billing practices
  • Advanced Other Knowledge of report automation
  • Intermediate Other Ability to effectively research issues and resolve problems
  • Intermediate Other Process orientation; understanding of process design and flow and associated analytical tools and techniques
Licenses and Certifications:
A license in one of the following is required:
Technical Skills:
  • Required Intermediate Xcelys
  • Required Intermediate SQL Server System SAS, SQL
  • Required Intermediate Statistical Analysis Systems (SAS)
  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft PowerPoint
  • Required Intermediate Other Knowledge of CPT/HCPCS coding
  • Preferred Intermediate Other Knowledge of database driven programs
Languages:

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Last Updated On: 12/9/2015