What are the responsibilities and job description for the HealthEdge Configuration Analyst position at Brooksource?
HealthEdge Configuration Analyst
Contract-to-hire
The HealthEdge Configuration Analyst will work as part of a multidisciplinary consulting team to implement the HealthRules Payor (HRP) platform for a health insurance payer client. This role focuses on configuring the HRP platform, collaborating with cross-functional teams to understand business requirements, translating these requirements into system configurations, and ensuring the platform operates efficiently and aligns with the client’s business processes.
Responsibilities
Configuration Management:
- Configure and customize the HRP platform, including benefit plans, provider networks, and business rules, to meet client requirements.
- Ensure compliance with payer-specific guidelines, regulatory requirements, and organizational standards.
Requirements Analysis:
- Collaborate with business analysts, project managers, and client stakeholders to gather and analyze business requirements.
- Translate requirements into technical specifications for system configuration.
Testing and Validation:
- Develop and execute test plans to validate system configurations and ensure accuracy in claim adjudication, member management, and provider integration.
- Troubleshoot and resolve issues identified during testing or post-implementation.
Documentation and Training:
- Document configuration changes, processes, and workflows to ensure traceability and facilitate knowledge transfer.
- Provide training and support to end users and internal teams on the configured HRP platform.
Collaboration and Support:
- Serve as a liaison between the client and technical teams to address configuration needs and system improvements.
- Assist in post-implementation support and enhancements as required.
Requirements
- Strong understanding of HealthEdge HealthRules Payor platform architecture and components.
- Experience with claims processing, benefits configuration, and provider network setup.
- Familiarity with SQL and relational databases for querying and data validation.
- In-depth understanding of healthcare payer operations, including claims adjudication, member management, and provider contracting.
- Familiarity with CMS guidelines, HIPAA compliance, and other regulatory standards.
- Excellent analytical and problem-solving skills.
- Strong written and verbal communication abilities.
- Effective collaboration with multidisciplinary teams in a consulting environment.
- Previous experience working in consulting roles for healthcare payers.
- Exposure to agile project management methodologies.
Education and Experience
- Bachelor’s degree in Computer Science, Information Systems, Healthcare Administration, or a related field.
- 3 years of experience configuring and implementing healthcare payer platforms, preferably HealthRules Payor (HRP).
