This position specializes in the analysis and application of intermediate level benefit plan design requirements. A successful Analyst will ensure a high level of quality and accuracy through benefit configuration, test execution and validation efforts while serving as a subject matter expert on benefits and claim adjudication system coding setup.
Analyzes new business requirements for benefit design changes to establish the appropriate solution.
Complies with standards set forth regarding benefit design and configuration including but not limited to Health Insurance Portability and Accountability Act of 1996 (HIPAA) and National Council for Prescription Drug Programs (NCPDP).
Maintains technical documentation based on standard operating procedures.
Partners with various teams to analyze customer specific requirements and configuration and translate those into technical design specification and data flow from which programs are developed and coded.
Actively participates in and contributes to daily communications, team meetings and project/issue resolution.
Responsible for accurate management of plan benefits coding changes, test execution and validation efforts of plan benefit design requests.
Maintains customer documentation that validates configuration.
Efficiently and effectively distributes tasks, using clear and concise instructions and expectations.
Completes deliverables independently and within an agile team setting.
Other duties as assigned.
Other Job Requirements
Responsibilities
Up to 2 years of experience in benefit plan configuration/analysis.
Experience with adjudication processes (FirstRx preferred), analyzing benefit plan design and system application.
This role requires strong attention to detail, critical thinking and analytical skills
Strong working knowledge of Microsoft Office suite, specifically Word and Excel, including running queries and macros.
Ability to work within a team and as an individual contributor in a fast-paced, changing environment.
Ability to identify and resolve process and/or systems issues.
Strong sense of urgency leading to the timely completion of all projects, training and assignments.
General Job Information
Title
Benefit Plan Configuration Analyst
Grade
20
Work Experience - Required
Benefit Plan Configuration
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelors
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
