Hybrid Associate Configuration Analyst

at Abarca Health

• Job title: Associate Configuration Analyst
• Job type: Full Time
• Experience level: Junior, Mid level
• Salary: Not specified
• Degree requirement: Associate's Degree
• Tech skills: Tableau
• Location requirements: Hybrid, San Juan, Puerto Rico

About the role

• Associate Configuration Analyst at Abarca Health managing configurations for Medicare, Medicaid, and Commercial clients while ensuring compliance and accuracy in operations.

Responsibilities

• Process plan configuration setup for new Medicare, Medicaid, Commercial and Employer client implementations, as well as configuration changes for existing clients.
• Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation.
• Perform research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action.
• Apply appropriate sense of urgency support to other areas to verify and analyze claims processing cases, eligibility, and other operational situations and issues referred for validation within SLAs/SLOs.
• Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met.
• Support the review, impact analysis, root cause assessment and preventive measures for issue management related workload.
• Continuously develop an understanding of Darwin (proprietary adjudication platform) system logics to ensure benefit designs are configured to meet client requirements with accuracy.
• Make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations of Medicare, Medicaid and State Requirements.
• Collaborate and coordinate with other business units to execute configuration as required.
• Provide feedback on processes and make recommendations for improvements.

Requirements

• Associate or Bachelor’s degree in Accounting, Finance, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
• Experience utilizing dashboard tools, (e.g., Tableau, QVW, and Excel tools).
• 1+ years of work-related experience in benefit configuration, Medicare Part D.
• Ability to apply critical thinking skills to manage responsibilities.
• Ability to manage presentations as needed.
• Excellent oral and written communication skills.
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Benefits

• Flexible hybrid work model requiring certain on-site workdays (Puerto Rico Location Only)