Healthrules Payer Configuration Lead

Summary: As a Configuration Lead specializing in HealthRules Payer, you will oversee payer system configuration, benefit design, and delivery leadership. This role requires collaboration with various stakeholders to ensure effective design and implementation of benefit components. Your expertise in healthcare payer systems will be crucial in driving successful outcomes. The position is remote, allowing for flexibility in work arrangements.

Key Responsibilities:

• Work closely with Business SMEs, Sales, internal teams, employer groups, and vendors for: Requirements gathering, Design & architecture discussions
• Responsible for design and configuration of Benefit components in HealthRules Payer
• Ability to extract and analyze benefit data using SQL
• Support data profiling and migration activities (legacy HealthRules Payer)
• Design, develop, test, and document interfaces of moderate-to-high complexity
• Maintain documentation and version control
• Provide technical leadership and mentor team members
• Support testing and deployment of configurations in production environment
• Lead a team of Configuration Analysts (including production support)

Key Skills:

• Healthcare Payer business functions and IT systems
• Strong experience in HealthRules Payer platform
• Hands-on experience with Products & Benefits, Claims Workflow
• Strong understanding of US Healthcare Payer streams: Claims, Network & Pricing, Provider Management, Medical Management, Premium Billing & Payment, Member Enrollment, Benefits Management
• Experience across Commercial, TPA, Self-Funded, and Blues business
• Experience with Core Administrative Processing Systems: HealthRules Payer (primary), Facets / QNXT (nice to have)
• HealthRules Payer Configuration: Benefit Plan setup, Product configuration, Benefits & Claims configuration

Salary (Rate): undetermined

City: undetermined

Country: undetermined

Working Arrangements: remote

IR35 Status: undetermined

Seniority Level: undetermined

Industry: IT