Hybrid Associate Configuration Analyst

Posted 3 weeks ago

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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)

Job title

Associate Configuration Analyst

Job type

Experience level

JuniorMid level

Salary

Not specified

Degree requirement

Associate's Degree

Tech skills

Location requirements

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