HRP Technical Analyst

Overview

Remote
$60 - $70
Contract - Independent
Contract - W2
Contract - 18 Month(s)
No Travel Required

Skills

Business Analysis
Business Analytics
Business Data
Analytical Skill
Medicare
Health Care
Finance

Job Details

HealthRules Payer (HRP) Technical Analyst

As an HRP Technical Analyst, you must be highly organized and detail-oriented, with strong analytical, problem solving, and prioritization skills. You should also be able to handle multiple tasks in a fast-paced, deadline-driven environment, both independently and as part of a team. It is also important that you display excellent verbal and written communication and interpersonal skills, as well as the ability to effectively present information and respond to questions from groups of managers and clients.

Responsibilities: -

Understanding of Benefit Terminologies: Copay, Coinsurance, Deductible, Limits, and Pre-auth etc.

Knowledge of different line of business e.g. Commercial, Medicare, Medicaid, ASO, HIX, and Fully Insured, etc

Excellent design and technical skills with Oracle PLSQL and/or SQL Server Development (including stored procedures, views, packages, functions, triggers)

Gather Business requirements and deliver business analytics base solutions using structured/unstructured business data to help achieve measurable business outcomes for clients.

Good knowledge on US health care and payor business functions

Perform configuration of product, service categories, value list, BPC, Benefit plan.

Perform configuration of Network, Supplier Contract, Fee Components, Fee Schedule,

Should be able perform due diligence in understanding client current system and creating benefit plans based on benefit plan document.

Good to have HE Certified BA (Business Analyst)

Experience: -

8-12+ Technical / Hands on

Location: -

US

Canada

Educational Qualifications: -

Bachelor s degree in computer science, information technology or a similarly relevant field is highly preferred.

Skills: -

Mandatory Technical skills: -

HRP Hands on prior experience

Good experience in healthcare (Health Plan) domain - Member, Provider, Claims and/or Finance

Highly skilled in Oracle/SQL Server Development and programming

HealthRules payor, HealthRules Designer, HealthRules Manager

Benefit Plan configuration and Supplier Contract Configuration

Excellent knowledge of SQL

Good to have skills: -

Good knowledge of XML

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.