Managed Care Benefit Configuration Specialist
Managed Care Benefit Configuration Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
Overview
Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.
Responsibilities
***This position is remote but will be expected to work PST business hours (8am-5pm PST).
Position Summary:
The Benefit Configuration Specialist will implement new client benefit setup and hierarchy based on the specific needs of the customer. Benefit setup based on plan design changes of existing customers. Configures all aspects of benefit plan per health plan utilizing the Financial Risk Matrix for major commercial Medicare Advantage and Medicaid Health Plans. Create and maintain configuration templates when loading benefit information.
Responsibilities may include:
- Develop all hierarchy levels in managed care platform for customer setups and configuration
- Review and verify client setup is accurately reflected in platform
- Monitor as assigned all QA processes for benefit builds
- Follow and adhere to all Policies and Procedures for the benefit workflow within the managed care platform
- Support quality reviews and testing of all benefit setup prior to customer implementation and go-live date
- Ensure health plan configuration within system templates related plans and benefits are updated as needed as well as tested and audited if issues are found in Benefit Configuration
- Partner with Compliance department to audit client setups and configuration post go-live
- Resolve escalated and complex processing change requests issues or questions
Qualifications
Minimum Qualifications:
- 3 years experience with benefits configuration set up or implementation
- Associates degree or equivalent experience
Preferred Qualifications:
- Healthcare or pharmacy benefit management industry preferred
- Previous managed care platform working knowledge (ie: EZCAP QNXT HealthEdge) preferred
- Bachelors degree preferred
Required Experience:
Unclear Seniority
Employment Type
Unclear
