Configuration Analyst III

March 24

🏄 California – Remote

Although this job is listed in California, this company may be open to hiring remote in other states.

💵 $61k - $100.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

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MedImpact Healthcare Systems, Inc.

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MedImpact Healthcare Systems, Inc. is a pharmacy benefit manager that works with health plans to make pharmacy benefits more accessible and affordable for members. The company serves over 20 million members and handles more than $40 billion annually in pharmacy transactions. MedImpact provides a variety of services including medication reminders, home delivery, and more to empower individuals to manage their prescriptions effectively. By leveraging technology and resources, MedImpact aims to offer a better choice within the pharmacy benefits market and supports health solutions in ensuring convenient and reliable access to medications for its members.

PBM • Technology • Customer service • Pharmacy benefits management • Healthcare

1001 - 5000 employees

Founded 1988

⚕️ Healthcare Insurance

💊 Pharmaceuticals

☁️ SaaS

💰 $1.4M Seed Round on 2013-09

📋 Description

• The Configuration Analyst provides support for the client configuration of benefits, pharmacy and formulary; supporting the intake, design, configuration, and in-unit testing of all change requests for assigned clients. • Leads and provides support on more complex internal and external client configuration projects. • Clear understanding of the POS adjudication logic, providing support to divisions within the organization where needed to meet common goals and strategic initiatives. • Ensures appropriate levels of service and support to assigned clients by understanding and championing clients’ configuration design requirements throughout the organization, including client business model, targeted markets, design objectives, pharmacy network composition, and overall claims adjudication expectations. • Uses standardized methodology to document requirements, detailing any custom maintenance processes and configuration best practices, and ensures that appropriate rationale exists for non-standard designs and that all efforts are undertaken to prevent inefficient and non-sustainable configuration structures. • Applies pharmacy, formulary, and benefit configuration to effectuate change as specified in submitted change requests. • Ensures assigned due dates for submitted change requests are met. • Acquires a thorough understanding of Laker Pharmscreens logic for claims adjudication, system constraints, conflicting benefit logic configurations, benefit coding table designs, plan – group – pharmacy carrier to benefit linking, to ensure proposed design satisfies the intended solution. • Troubleshoot and perform research on basic to moderately complex claims processing issues or customer inquiries and promptly responds to service failures, resolves issues, and escalates concerns as appropriate. • Ensures a consistent customer experience by proactively participating in configuration of plan designs and pharmacy networks through consultation and collaboration with external clients, client team members, other internal business partners, to ensure that business requirements for change requests are clearly understood, documented, developed, communicated, tested, and delivered flawlessly. • Uses standardized methodology to ensure that appropriate rationale exists for non-standard designs and that all efforts are undertaken to prevent inefficient and non-sustainable configuration structures. • Perform in-unit testing and validation to confirm configuration design processes as expected and meets customer requirements and that all appropriate forms and documentation are fully and accurately completed. • Utilizes project planning, prioritizing, and organizational skills to ensure timely deliverables, high levels of quality, and efficient use of resources to achieve claims adjudication accuracy. • Performs all workflow activities including preassessment, design, configuration and in-unit testing of network and plan configuration requests. • Assist Level I Analyst with training, Ambassadorship, and complex configuration support. • Assists in creating and maintaining documentation of clients’ plan designs, detailing any custom maintenance processes and configuration best practices. Includes documentation of adjudication hierarchies, edits, restrictions, tables, carriers, and other configuration components.

🎯 Requirements

• Associates degree (A.A.) from a College or university, or a minimum of three (3) years related experience and/or training, or equivalent combination of education and experience. • Previous healthcare or PBM experience desired. • Experience with pharmacy or medical claims analysis desired. • In-depth drug knowledge and terminology is a plus. • Intermediate knowledge of MS Office / Word, PowerPoint, Outlook and MS Excel. • The ability to run SQL queries and script load is a plus. • Pharmacy Technician License or National Certification helpful.

🏖️ Benefits

• Medical / Dental / Vision / Wellness Programs • Paid Time Off / Company Paid Holidays • Incentive Compensation • 401K with Company match • Life and Disability Insurance • Tuition Reimbursement • Employee Referral Bonus