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Abarca Health · 1 day ago

Associate Configuration Analyst

United States

Full-time

Remote

Entry Level

1+ years exp

Abarca Health is igniting a revolution in healthcare by redefining pharmacy benefits with smarter technology. The Associate Configuration Analyst will be responsible for process plan configuration setup for various client implementations, performing unit testing, and resolving operational issues related to claims processing.

Health CareInformation Technology

No H1B

Responsibilities

Process plan configuration setup for new Medicare, Medicaid, Commercial and Employer client implementations, as well as configuration changes for existing clients

Perform unit testing to confirm configuration set-up or changes are processing as expected as defined in the client documentation

Perform research and resolution of adjudication and processing issues including, identification of root cause, impact analysis determination and corrective action

Apply appropriate sense of urgency support to other areas to verify and analyze claims processing cases, eligibility, and other operational situations and issues referred for validation within SLAs/SLOs

Responsible for daily tracking and monitoring of assigned requests to ensure due dates are met

Support the review, impact analysis, root cause assessment and preventive measures for issue management related workload

Continuously develop an understanding of Darwin (proprietary adjudication platform) system logics to ensure benefit designs are configured to meet client requirements with accuracy

Make timely adjustments to operations ensuring our processes follow compliance, rules, and regulations of Medicare, Medicaid and State Requirements

Collaborate and coordinate with other business units to execute configuration as required

Provide feedback on processes and make recommendations for improvements

Qualification

Benefit configurationMedicare Part DDashboard toolsCritical thinkingOral communicationWritten communication

Required

Associate or Bachelor's degree in Accounting, Finance, or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)

Experience utilizing dashboard tools, (e.g., Tableau, QVW, and Excel tools)

1+ years of work-related experience in benefit configuration, Medicare Part D

Ability to apply critical thinking skills to manage responsibilities

Ability to manage presentations as needed

Excellent oral and written communication skills

This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members

This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable)