Job Description

6-12 + Month Contract

ON SITE _ Providence RI

Local W2 Candidates only

HRP (HealthRules Payer) configuration analyst is responsible forconfiguring and maintaining the HealthRules Payer system. Support and configure appropriately to manage claims, benefits, and provider contracts.

• Responsible for the analysis, design, build, testing, implementation, and maintenance of system configuration to support business requirements and optimize system functionality.
• Key responsibilities include analyzing business requirements, creating and documenting configuration designs, collaborating with stakeholders, and performing testing to ensure the system accurately reflects business rules for different lines of business.
• Work with cross-functional teams to develop an understanding of the Health Rules Payor system capabilities and evaluate requirements to determine configuration design.
• Learn and understand the HRP system and processes
• Create, edit, modify and update Benefits plans within the system.
• As part of an agile approach, build out and test various system configuration items including Benefits, Provider Contracts, Members, and Claims. This includes: Researching, analyzing, and maintaining code sets when required.
• Research and analyze annual updates to fee schedules, rates, and contracts as defined by Medicare and Medicaid leveraging analytical skills to support the contract and fee schedule creation and maintenance found on the CMS website.

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