Administrative Systems Analyst I, II or III

Utah Retirement Systems•Salt Lake City, UT

10d•Hybrid

About The Position

PEHP Health & Benefits is hiring an Administrative Systems Analyst at level I, II, or III. The Administrative Systems Team supports PEHP’s core administrative systems, which manage benefits and payments. The role assists with evaluating, testing, and implementing benefits and payment-structure changes in PEHP administrative systems. It requires analytical skills for complex business and product setup analysis, a strong understanding of benefits systems, problem-solving skills across projects of varying complexity, and the ability to work semi-independently and meet deadlines. The analyst helps configure benefits plans, analyze source documents, set up code sets and clinical guidelines, create and execute tests, coordinate configuration releases, and validate production changes. The role also contributes to process optimization through data analysis, root-cause investigation, Lean methods, report improvements, request tracking, and configuration standards. The analyst prepares explanatory information for other departments and provides project updates to management. PEHP offers competitive compensation, generous benefits, personal development in a positive team environment, and work-life balance. Remote work is available for nine out of every ten workdays for most jobs. This position performs in a typical climate-controlled office setting and involves routine activities such as walking, standing, stooping, sitting, reaching, talking, hearing, and seeing.

Requirements

For level I: High school diploma and four years of relevant managed-care or health-plan business analysis or system software configuration experience, or an equivalent combination of education and experience.
For level II: High school diploma and six years of relevant managed-care or health-plan business analysis or system software configuration experience, or an equivalent combination of education and experience.
For level III: High school diploma and eight years of relevant managed-care or health-plan business analysis or system software configuration experience, or an equivalent combination of education and experience.
Intermediate knowledge of implementation processes within claims operations or product management environments.
Ability to gather, analyze, and communicate complex requirements clearly to technical and non-technical staff.
Familiarity with medical terminology, CPT4, ICD10, and HCPCS medical coding, provider contract concepts, and common claims processing and resolution practices.
Knowledge of project tracking, testing, and requirements tools, including Microsoft Project, SharePoint, and JIRA.
Microsoft Excel skills.
Working knowledge of PEHP standards and contract compliance.
Excellent communication skills, including the ability to communicate effectively across departments and respond professionally to common inquiries or complaints.
Strong attention to detail; ability to follow written and verbal instructions, prioritize and multitask, follow through on assignments, and meet deadlines.
Ability to manage workload and time-deadline stress and work effectively both independently and in a team.
Demonstrate judgment, high integrity, and personal values consistent with URS values.
The work requires walking, standing, stooping, sitting, reaching, talking, hearing, seeing, and common eye, hand, and finger dexterity.

Nice To Haves

A bachelor’s degree with a strong emphasis in information technology, information systems, business, data analytics, or a related field.
PEHP experience; three years is preferred for level II and four years for level III.
Experience with HealthRules Payor and HealthRules Care Manager.
Certified coder; preferred for levels II and III.

Responsibilities

Assist with ongoing evaluation of benefits configurations for new and existing plans in HealthRules Payor, HealthRules Care Manager, associated interfaces, and third-party systems.
Analyze explanation of benefits documents and master policies to support correct and efficient implementation.
Assist with setting up code sets and clinical guidelines used in benefits configuration and provider payments.
Help create test scripts, including regression cases, and test system functionality, enhancements, and bug fixes; develop and execute test plans.
Help organize the release of benefits configuration changes to production to reduce migration conflicts.
Assist with production validation and audits to ensure the quality and integrity of benefits change implementations.
Maintain a strong understanding of HealthRules Payor and HealthRules Care Manager features and capabilities, associated interfaces, and dependencies on other systems.
Collect and analyze data to assess and resolve operational obstacles to benefits design optimization.
Assist with root-cause analysis of benefit setup issues and proposed setup changes.
Apply Lean principles and methodologies to process and workflow design.
Identify opportunities to improve operational reports related to new business implementation processes.
Help track incoming requests and issue resolutions using productivity monitoring tools.
Assist in developing configuration standards and best-practice guidelines, making recommendations where appropriate.
Help develop explanatory information so other departments can better understand administrative system configuration.
Provide project and informational updates to management as available or assigned.
Maintain regular and reliable attendance.
Maintain strict confidentiality in accordance with applicable federal and state law and PEHP policy.
Perform other duties as required.