Senior Provider Configuration Analyst (Health Edge, Burgess, Provider Pricing, Fee Schedule, Contract Configuration)

Scope of Role & Responsibilities

• Configure provider reimbursement and create and maintain fee schedules.
• Analyze departmental requirements needed to develop long and short-term plans.
• Ensure system processes and services are aligned with the needs of the department.
• Analyze the system to ensure claims are processed correctly to protect the company from liabilities.
• Collaborate with MetroPlusHealth’s system consultants to correct errors, rectify omissions, and investigate system issues.
• Identify potential system problems for claims resolution.
• Review test cases to ensure they are in accordance with requirements and assist with overall testing processes.
• Conduct ongoing reviews of systems and processes to ensure accurate and optimum setup for both provider and claims.
• Receive, coordinate, and manage requests for Systems Modifications.
• Maintain and track open issues and coordinate release testing.
• Absorb and assist with any other functions as required by the Director of Provider Contract Configuration.
• Participate in special projects and strategic initiatives as needed.

Required Education, Training & Professional Experience

• A Baccalaureate Degree from an accredited college or university required, Computer Science preferred;
• Six (6) years of progressive, responsible experience in configuration for data processing, computer systems and applications;
• Experience with HealthEdge HRP and Source products required.
• Demonstrated experience supporting system configuration, workflow analysis, and technical documentation in a healthcare or claims environment.

Professional Competencies

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication
• Ability to work independently, manage multiple priorities, and maintain attention to detail.