Managed Care Benefit Configuration Analyst

Commonspirit; Bakersfield (CA); Remote; Full time

Job summary

An established industry player is seeking a Managed Care Benefit Configuration Analyst to join their team. This remote role focuses on implementing client benefit setups and ensuring accurate configuration in managed care platforms. The successful candidate will have the opportunity to work with cutting-edge technology while supporting quality assurance processes and collaborating with compliance teams. With a commitment to providing quality managed care services, this organization offers a comprehensive rewards package, including flexible health benefits, a generous retirement plan, and paid time off. If you have a passion for healthcare and a background in benefits configuration, this is the perfect opportunity for you to make a meaningful impact.

Benefits

Flexible Health Benefits

401k Retirement Plan

Paid Time Off

Sick Leave

Qualifications

• 3+ years of experience in benefits configuration or implementation.
• Associate's degree or equivalent experience required.

Responsibilities

• Implement new client benefit setup based on customer needs.
• Monitor QA processes for benefit builds and ensure accuracy.

Skills

Benefits Configuration

Client Setup

Quality Assurance Processes

Problem Solving

Education

Associate's Degree

Bachelor's Degree

Tools

EZCAP

QNXT

HealthEdge

Job description

Managed Care Benefit Configuration Analyst

Join to apply for the Managed Care Benefit Configuration Analyst role at CommonSpirit Health.

*Overview*

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans, and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical, dental, and vision plans for the employee and their dependents, Health Spending Account (HSA), Life Insurance, and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.

*Responsibilities*

This position is remote, but will be expected to work PST business hours (8am-5pm PST).

Position Summary

The Benefit Configuration Analyst will implement new client benefit setup and hierarchy based on the specific needs of the customer. Benefit setup based on plan design changes of existing customers. Configures all aspects of benefit plan per health plan utilizing the Financial Risk Matrix for major commercial, Medicare Advantage, and Medicaid Health Plans. Create and maintain configuration templates when loading benefit information.

Responsibilities May Include

• Develop all hierarchy levels in managed care platform for customer setups and configuration.
• Review and verify client setup is accurately reflected in platform.
• Monitor as assigned all QA processes for benefit builds.
• Follow and adhere to all Policies and Procedures for the benefit workflow within the managed care platform.
• Support quality reviews and testing of all benefit setup prior to customer implementation and go-live date.
• Ensure health plan configuration within system templates, related plans and benefits are updated as needed as well as tested and audited if issues are found in Benefit Configuration.
• Partner with Compliance department to audit client setups and configuration post go-live.
• Resolve escalated and complex processing, change requests, issues, or questions.

Qualifications

Minimum Qualifications

• 3+ years experience with benefits configuration, setup, or implementation.
• Associate's degree or equivalent experience.

Preferred Qualifications

• Healthcare or pharmacy benefit management industry preferred.
• Previous managed care platform working knowledge (ie: EZCAP, QNXT, HealthEdge) preferred.
• Bachelor’s degree preferred.

Pay Range

$25.25 - $36.61 /hour

Seniority level

• Not Applicable

Employment type

• Full-time

Job function

• Health Care Provider
• Industries: Wellness and Fitness Services, Hospitals and Health Care, and Medical Practices