“Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is through powerful relationships with Care Partners, we help all people live healthy and brighter lives. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright employees to embody and uphold our core values in work and interactions, both internal and external: be brave, be brilliant, be accountable, be inclusive, and be collaborative.
The Senior Configuration Analyst is a critical member of the Health Plan Operations team and helps to support all Fee Configuration activities and develop and recommend complex configuration solutions to Network contract agreements. This individual serves as the senior team member available for consultative inquiries from functional areas and is responsible for training and mentoring entry-level Configuration Analyst.
- The Senior Configuration Analyst description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Build fee schedules based on contract rates and language
- Yearly full fee schedule updates based on Medicare’s first quarter update
- Work with TPA to ensure fee schedule builds will auto adjudicate
- Maintain quarterly fee schedule updates and maintenance based on Medicare
- Partner with the Network Contracting team to solution on complex contracting terms
- Audit claims adjudication for compliance with contract rates and terms
- Assist cross functionally when needed
- Other duties and responsibilities as assigned
- This position does not have supervisory responsibilities.
- The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- Minimum high school diploma or GED is required; Associates or Bachelor’s degree preferred
- Five (5) or more years’ experience in a like role required; Seven (7) or more years of experience in lieu of a Bachelors degree
- Communication skills (verbal and written) are critical
- Must be organized and be able to prioritize work to meet deadlines
- Working independently with little supervision
- Experience in commercial and Medicare fee schedule buildout required
- Genelco background preferred
At Bright Health, we brought together the brightest minds from the health care industry and consumer technology, and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized, and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities, we are reshaping how people and physicians achieve better health together.
We’re Making Healthcare Right. Together.
We've won some fun awards like Modern Healthcare and Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our team!
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.