Overview
Remote
Full Time
Skills
SQL
claims
Provider
Oracle OR SQL Server
HealthRules Payor
Health Plan
HealthRules Manager
HealthRules Designer
Job Details
Hi Professionals,
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
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
"Disclaimer: E-Solutions Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. We especially invite women, minorities, veterans, and individuals with disabilities to apply. EEO/AA/M/F/Vet/Disability."
HRP Technical Analyst1SQL,claims,Provider,Oracle OR SQL Server,HealthRules Payor,Health Plan,HealthRules Manager,HealthRules DesignerN/AFull TimeUnited States
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