TITLE: HEALTHRULES CONFIGURATION ANALYST

DURATION: 10-12 MONTHS

LOCATION:  REMOTE

We are looking for a seasoned Healthrules Payer Configuration Analyst, who has experience and will be comfortable having responsibility to design, configure, test, implement and maintain HealthRules Payor and Amisys pricing, claims and/or benefit configuration, according to business requirements, to support accurate and efficient claims processing and data reporting.  You will investigate and resolve configuration-related provider, member and claim processing issues and assist other departments in understanding HealthRules Payor and Amisys configuration.  Lastly, you will lead complex configuration projects, annual readiness configuration and care system contract implementations.

WHAT YOU'LL DO: 

• Develop and maintain an understanding of current HealthRules Payor and Amisys configuration, contracts, products and policies.
• Analyze, configure, test, implement and maintain HealthRules Payor and Amisys to support changes in contracts, products, legislation, and client policies and procedures, ensuring timely maintenance and updates of configuration.
• Test, implement and train on new HealthRules Payor and third party product releases, modules and updates.
• Assist in the development of test scenarios for changes and/or projects. 
• Manage the timely resolution of open testing bugs and issues. 
• Develop and monitor post-production audit reports to ensure the intent of change and/or project requirements is being met.
• Develop and maintain configuration documentation and communicate changes, as appropriate.
• Work with Technical Business Analyst, UAT and QA to create detailed functional requirements that support and align to business requirements and testing scenarios.
• Research and respond to service requests in a prompt and timely manner and update or build configuration in HealthRules Payor and Amisys, as needed.
• Recommend and draft new and updated procedures to maximize the use of HealthRules Payor, Amisys and other third-party products to improve efficiency.
• Develop and maintain good working relationships with the staff of other departments including Provider Relations & Contracting, Healthcare Economics, Provider Assistance Center, Government Relations, Product, and Coverage Policy.
• Inform leader and peers of changes that will impact the client.
• Research and recommend methods to improve or implement necessary changes in a prompt and efficient manner.

_You'll Be Successful If:  _

• HealthRules Payer Configuration experience including Enrollment, Account setup, Provider/Pricing, Benefits, and Claims configuration.
• Five years of configuration experience or a combination of claims processing, healthcare system operations, data analytics and configuration. 
• Must possess working knowledge of managed care operations, system development and testing. 
• Microsoft Office proficiency.

_WHAT YOU'LL BRING:  _

• HealthRules Payer: Manager & Designer knowledge & experience 
• Five years of configuration experience or a combination of claims processing, healthcare system operations, data analytics and configuration. 
• Must possess working knowledge of managed care operations, system development and testing. 
• Bachelor's degree in business or health care preferred; demonstrated work experience may be considered in lieu of degree.

PREFERRED EXPERIENCE:

• Experience using Business Objects.
• Ability to build and maintain relationships across the enterprise.
• Strong knowledge of government programs, regulations and benefits.
• Previous experience with CMS, DHS or payer reimbursement methodologies and /or payment policies.
• Knowledge of or experience with Optum Claims Editing System (CES) and Axiom TranSend.

_ _

ABOUT IMPRESIV HEALTH: 

Impresiv Health is a healthcare consulting and staffing partner specializing in operations management consulting and business optimization services for companies across the healthcare continuum. Started on the belief that a firm's foundation could be built with a team of thought leaders and proven industry experts, we've established a company that delivers quick and efficient results for our clients. ​ 

We offer strategic business and technical management consulting services, and a suite of staffing solutions. ​ 

Impresiv Health is a services partner with a focus on expediting time-to-value. It's not just our goal to immediately deliver greater returns on your investment in us as a partner—it's our reputation. ​ 

QUICKER, EFFICIENT, AND AFFORDABLE. THAT'S IMPRESIV!