Perform system configuration of provider contracts for health care providers into the HealthEdge’s HealthRules system. Responsibilities will span functional design where provider contract specifications are interpreted into the proper business rules and components for configuration in the system to drive system functionality. This role will also liaison with provider contracting, networking and relations business resources.Read more of the job descriptionRead LessQualificationsMinimum of Six (6) months Functional business experience in the health payer industry, specifically in supplier contracts and pricing rules, claims adjustments or appeals or benefits configuration Experience with Medicare and custom fee schedules and interpreting professional, facility and ancillary provider contractsMinimum of Six (6) months experience implementing or supporting HealthEdge HealthRules software preferredMinimum of 3 years configuration experience on similar payer systems (e.g. Facets)Experience working on a full life cycle project adhering to Software Development Life Cycle (SDLC)Proficient in Healthcare and Health Plan terminology and coding preferredStrong communication, analytical and problem solving skillsWhat We Believe
Perform system configuration of provider contracts for health care providers into the HealthEdge’s HealthRules system. Responsibilities will span functional design where provider contract specifications are interpreted into the proper business rules and components for configuration in the system to drive system functionality. This role will also liaison with provider contracting, networking and relations business resources.Read more of the job descriptionRead LessQualifications
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