Configuration Analyst

Configuration Analyst

Configuration Analyst

Who are we?

Versant Health is one of the nation's leading administrators of managed vision care, serving millions of our clients' members nationwide. We are driven by our mission to help members enjoy the wonders of sight through healthy eyes and vision.

As a Versant Health associate, you can enjoy a comprehensive Total Rewards package, which includes health and dental insurance, tuition reimbursement, 401(k) with company match, pet insurance, no-cost-to-you vision insurance for you and your qualified dependents. We are also invested in your success. There are many opportunities for advancement and development throughout all stages of your career with us.

See how you can make a difference with the support of strong leadership and a team environment.

See Everything, Be Anything™.

What are we looking for?

Responsible for timely and accurate implementation of enterprise-wide core system configuration solutions including activities related to new health plan implementations and conversions as well as provider reimbursement configuration agreements across multiple benefit management platforms. Also responsible for the ongoing maintenance and set-up within the benefit management platforms. The Configuration Analyst works independently on the implementation of vision benefit programs in that support client program requirements gathered through the sales process.

Where you will have an impact

• Follow Quality Assurance and Quality Control procedures to maintain configuration accuracy and consistency.
• Continually monitor work processes for potential improvements, ensuring a highly efficient workflow and department compliance measures from the Annual SSAE-16 Audit.
• Provide direct support to all business areas of the company regarding benefit plans, new group setup and maintenance, workflows, user defined tables and related structures.
• Advise end users in planning and implementing new products as they relate to benefit management platform functionality and configuration.
• Process and track requests for provider fee schedule updates for both commercial and health plan in an accurate and timely fashion.
• Maintain dictionary / master files, including but not limited to research, set-up and maintenance of all diagnosis, CPT, HCPCS and other medical codes as identified.
• Implement cross functional workflows which support claims processing, customer service, premium billing, new and renewing group enrollment, utilization management.
• Provide configuration support to EDI, Web, and Reporting development activities.
• Configure and maintain the claim processing system mapping and all interface modules.
• Facilitate root-cause analysis and appropriate corrective action to communicate, rectify and prevent future incidents for identified issues and opportunities.
• Analyze business rules associated with claim payment, adjudication, and benefit administration / provider reimbursement.
• Create, test and maintain Benefit Plan additions, terms and changes.
• Generate data analysis and system configuration review via core systems reporting and custom SQL queries.
• Implement cross functional work processes which support claims processing and proper provider payment.
• Responsible for maintenance of Benefit Plan mapping parameters throughout the system.
• Support claim system upgrades and participate on User Acceptance Testing process.
• Involved in company configuration of all new client and provider implementations.
• Follow detailed setup procedures in complex claims / benefit plan systems.
• Perform assigned daily work to meet all internal and external service level expectations.
• Perform initial and peer-to-peer level quality review and test procedures to ensure all components of benefit programs are correct.
• Represent department with internal and external clients in standing and ad-hoc meetings.
• Provide peers with cross-training to ensure that consistent methodologies and best-practice strategies are utilized.
• Effectively work in a team atmosphere that includes all levels of organization.
• Display integrity and discretion to maintain confidentiality of all data.
• Perform lead projects and recommend / implement process for project completion.
• Perform project work as assigned by Management.

What's necessary to do the job?

HIPAA & Security Requirements

All Associates must comply with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as it pertains to disclosures of protected health information (PHI) as described in the Notice of Privacy Practices and HIPAA Privacy Policies and Procedures. As a component of job roles and responsibilities, Associates may have access to covered information, cardholder data or other confidential customer information which must be protected at all times. As a result, Associates must explicitly adhere to all data security guidelines established within the Company's Privacy & Security Training Program.

Versant Health will never request money from candidates who seek employment with us and will never ask for any payment as part of the recruitment process.

Versant Health is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at Versant Health without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic / civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

The wage range for applicants for this position is [$58,000.00 to $63,000.00].

All incentives and benefits are subject to the applicable plan terms.

Salary : $58,000 - $63,000