Healthcare Claims & Benefits Configuration Analyst (Facets) | Mason, OH 45040 (Hybrid) Job at Azaaki, LLC, Mason, OH

NEhmTThjOXZxbm40Y0k5bXphT3VnS3ZyS3c9PQ==
  • Azaaki, LLC
  • Mason, OH

Job Description

Healthcare Claims & Benefits Configuration Analyst (Facets)

Location: 4000 Luxottica Place, Mason, OH 45040 (Hybrid 2 days per week onsite)

Duration: 3 Months with possible extension

Work Hours: 8 AM to 5 PM EST (1-hour break; 40 hours/week)

Pay Rate: $50-55/hr. W2 All Inclusive

Role Overview

Serve as a Sr. Configuration Analyst on the Business Configuration Solutions team. Responsible for the enablement of member benefit configuration strategies by designing, implementing, and executing configuration. Lead projects for the Configuration space to enable system and process solutions for Business Configuration tool sets.

Key Responsibilities

  • Serve as a subject matter expert for the Business Configuration team supporting EyeMed's cross-functional teams to implement client requirements.
  • Lead/represent cross-functional meetings and capture business requirements.
  • Serve as a subject matter expert representing the Configuration workstream for large Government Implementations for Medicaid, Med/Surgical, and Medicare programs .
  • Provide data analysis and troubleshooting expertise on configuration tool sets with automated processes .
  • Prepare data for analysis by removing duplicates, errors, and outliers; perform data validation .
  • Build SQL queries to pull backend data based on configuration needs.
  • Serve as a Business Analyst documenting requirements, process flows , and executing testing for enhancements to improve the automation toolset.
  • Perform Fit/Gap Analysis and feedback assessments for new client plans.
  • Collaborate with leadership on configuration roadmap deliverables and automation of EyeMed's product and network offerings.
  • Self-manage and prioritize to meet SLAs and KPIs.
  • Build and maintain strong stakeholder relationships across EyeMed.

Must-Have Qualifications

  • Facets experience
  • SQL/Database expertise
  • Healthcare claims understanding and benefit configuration
  • Analytical & problem-solving capability
  • Experience with Oracle SQL for data validation and Facets for claims testing
  • Experience in Medicaid product configuration
  • Windows OS proficiency
  • Exposure to Informatica -based automation tools (EyeMed homegrown tool)

Preferred Qualifications

  • 5+ years experience with Facets platform
  • Experience with Medical Plan Benefit Configuration
  • Provider Network & Agreement Configuration
  • Knowledge of Medicare/Medicaid
  • Excellent communication and interpersonal skills
  • Fast learner with strong analytical skills

Education

  • Bachelor's degree or equivalent work experience

CANDIDATE SELF-ASSESSMENT: SKILL QUALIFICATION MATRIX

Please fill out the below matrix while applying. Use a scale of 1 (Beginner) to 10 (Expert) for the Self-Rating column.

Skill Category

Required or Preferred

Self-Rating (1-10)

Years of Experience

Notes / Comments

Facets Platform

Required

Healthcare Claims Knowledge

Required

Benefit Configuration

Required

SQL / Database

Required

Oracle SQL

Required

Medicaid Product Configuration

Required

Data Analysis & Troubleshooting

Required

Cross-Functional Leadership

Required

Process Documentation

Required

Testing & Validation

Required

Informatica / Automation Tools

Required

Medicare Knowledge

Preferred

Medical Plan Configuration

Preferred

Provider Network Configuration

Preferred

Communication & Interpersonal Skills

Preferred

Self-Prioritization / SLA Delivery

Preferred

Job Tags

Work experience placement, 2 days per week,

Similar Jobs

State of Florida

SENIOR HEALTH EDUCATOR - 64041301 Job at State of Florida

 ...Requisition No:867557 Agency: Department of Health Working Title: SENIOR HEALTH EDUCATOR - 64041301Pay Plan: Career Service Position Number:...  ...DEPARTMENT OF HEALTH - HILLSBOROUGH Division of Community Health Office of Minority Health Senior Health... 

Spire Orthopedic Partners

Sterile Processing Technician Job at Spire Orthopedic Partners

 ...What You'll Do Responsible for the day-to-day activities in Sterile Central. Responsible for decontamination, assembly of kits, operation...  ...sterilization, including all monitoring of these sterilization processes. Maintains adequate inventory for Sterile Central and Surgical... 

LaBella Associates

Environmental Analyst Job at LaBella Associates

 ...We are currently seeking a qualified Environmental Analyst to work in our Albany, Glens Falls, or Poughkeepsie office in our Environmental...  ...commensurate with experience. ~ Fast-paced environmental consulting/engineering practice. Salary Range: $50,000 - $60,000... 

Griswold Care Pairing for Sarasota County

CNA/HHA Job at Griswold Care Pairing for Sarasota County

Needing help with a client in Englewood for every saturday and sunday 8am-6:30pm. Client has dementia, needs help with meal prep and light housekeeping. Most of her meals need to be pureed. She has high anxiety so she needs to be assured that things are going to be ok.

AO Globe Life

Benefits Consultant VIRTUAL POSITION Job at AO Globe Life

 ...position, designed for new graduates ready to build professional experience in sales, client relations, and financial serviceswith full...  ...skills in sales, leadership, and client relationship management Work from anywhere with internetno commuting, no cubicle...