HRP Technical Analyst
Posted Today by 1757398321
Negotiable
Outside
Remote
USA
Summary: The HRP Technical Analyst role requires a highly organized individual with strong analytical and problem-solving skills to manage multiple tasks in a fast-paced environment. The position involves understanding healthcare benefit terminologies, performing technical configurations, and delivering business analytics solutions. Excellent communication skills are essential for presenting information and responding to client inquiries. A background in healthcare and technical expertise in Oracle PLSQL or SQL Server is crucial for success in this role.
Key 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)
Key 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 knowledge of XML
Salary (Rate): undetermined
City: undetermined
Country: USA
Working Arrangements: remote
IR35 Status: outside IR35
Seniority Level: undetermined
Industry: IT
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