HRP Configuration Lead Experience :
- 12 years of relevant experience.
Location :
Hybrid Morris Plains NJ or Tampa FL (Onsite once or twice a week).Primary Skills :
HealthRules PayerHealthRules LanguageHealthEdgeSecondary Skills :
Agile SAFeWhats in it for you
As an HRP Configuration Lead you will be part of an Agile team contributing to the development of healthcare applications and implementing new features while ensuring adherence to best coding and development standards.
Responsibilities :
Serve as a highly organized and detailoriented leader with strong analytical problemsolving and prioritization skills.Manage multiple tasks in a fastpaced deadlinedriven environment both independently and as part of a team.Exhibit excellent verbal and written communication skills along with strong interpersonal abilities.Effectively present information and respond to questions from managers clients and other stakeholders.Skill Requirements : Healthcare & IT Systems Expertise :
Deep understanding of Healthcare Payer business functions and IT systems.Knowledge of US Healthcare Payer workstreams including :Claims Processing Network & Pricing Provider Management
Medical Management Premium Billing & Payments Member Enrollments Benefits ManagementHIPAA X12 transactions (837I / P / D 834 270 / 271 835).Experience with various lines of business : Medicaid Medicare and Commercial insurance.Familiarity with industry standards and coding systems such as ICD10 HCPCS CPT Revenue Codes DRG APC and NDC .Expertise in Core Administrative Processing Systems (HealthRules Facets QNXT etc.).HealthRules Configuration & Implementation :
Configure Benefit Plans Network and Supplier Contracts (Pricing) Providers Enrollments Premium Accounts and Subaccounts within HealthRules.Collaborate with customers internal stakeholders and thirdparty vendors for requirements gathering architecture design development testing and implementation .Implement HealthRules as a claims adjudication system and integrate it into the existing application ecosystem.Architect design and deploy HealthEdge HRP components for claim administration.Integrate HealthRules API and Connector Services with required applications.Guide data profiling and data migration from legacy claims systems (e.g. Facets Amisys QNXT) to HealthRules.Maintain documentation of project deliverables and versioning.Mentor and guide teams on technology frameworks and best practices to ensure highquality deliverables.Support testing and deployment of HRP solutions.Architect design code test and document moderatetohigh complexity interfaces based on requirements.Educational Qualifications :
Bachelors degree in computer science information technology or a related field is highly preferred.Key Skills
Administrative Skills,Facilities Management,Biotechnology,Creative Production,Design And Estimation,Architecture
Employment Type : Full Time
Vacancy : 1
