Facets Configuration Analyst

Sr. Data Analyst

GENERAL FUNCTION
Serve as a Data Analyst on the Business Configuration team, responsible for provider agreement, fee schedule and network data integrity initiatives. Provide subject matter expertise for agreement, fee schedule and network setup. Partner with client cross functional teams to ensure efficiency and accuracy of configuration requests.

MAJOR DUTIES AND RESPONSIBILITIES

Writing SQL queries to extract data from the database, analysis of configuration data to identify clean-up activities.
Ensure agreement configuration accuracy that may impact provider payment and member responsibility.
Set up new Network and Agreement configurations into the Facets system.
Validate agreement and network configuration utilizing claims testing, SQL queries and Excel to ensure the configuration properly adjudicates during claims processing, for member benefit, reimbursements and provider pay amounts.
Perform and resolve network and agreement configuration questions/issues sent to the Business Configuration team without guidance.
Maintain relationships with Account Managers, and Provider teams in order to develop a cohesive cross functional, results driven working environment.
Self-manage completion of work inventory within established quality and turnaround time guidelines.
Coordinate and participate in cross-functional team activities for issue resolution.
Recommend process and system enhancements to drive improvements.
Support the management team with on-going training activities, misc. projects, resolving issues, and serving as a subject matter expert for all Configuration requests.

BASIC QUALIFICATIONS
Associate degree or equivalent experience required.
At least 5 years of experience working within a core claims administration system.
Good analytical and problem-solving skills
A minimum of 2 years’ experience writing SQL queries and exporting data from database tables.
Good communication and interpersonal skills
Ability to work independently or as a part of a team.
Ability to manage multiple complex assignments at once.

PREFERRED QUALIFICATIONS
3 years’ experience in Operations in the Healthcare industry
Experience understanding claim adjudication for member and provider reimbursements.
Experience with Facets platform using Claims, Provider, Network, Product Benefit Configuration
Knowledge of Medicare and Medicaid programs
SQL and Database experience

Specific Skills Needed:

Top 3-5 mandatory and/or minimum requirements
SQL/Database experience
Experience with health provider and network data elements
Experience with Facets in a managed care setting
Analytical & problem solving skills

Top 3-5 desirable attributes/qualifications?
3 years of experience focused on data analytics
Experience with Medicaid and/or Medicare programs and reporting
Superior communication, critical thinking, teamwork and project management skills
Experience with Claim adjudication and provider reimbursements

Required levels/ Years of Experience education – discuss whether there is flexibility
Bachelor’s degree or equivalent work experience

Notes:
Work hours: 8AM to 5PM – 1 hour break (8 hours a day , 40 hours a week)
Hybrid 2 days per week in office

Job Type: Contract

Pay: $46.40 - $48.00 per hour

Expected hours: 40 per week

Schedule:

• 8 hour shift

Ability to Commute:

• Mason, OH 45040 (Preferred)

Ability to Relocate:

• Mason, OH 45040: Relocate before starting work (Preferred)

Work Location: In person

Salary : $46 - $48