Magellan Health-posted 10 months ago
$45,655 - $68,485/Yr
Entry Level

This position specializes in the analysis and application of intermediate level benefit plan design requirements. A successful Analyst will ensure a high level of quality and accuracy through benefit configuration, test execution and validation efforts while serving as a subject matter expert on benefits and claim adjudication system coding setup. Analyzes new business requirements for benefit design changes to establish the appropriate solution. Complies with standards set forth regarding benefit design and configuration including but not limited to Health Insurance Portability and Accountability Act of 1996 (HIPAA) and National Council for Prescription Drug Programs (NCPDP). Maintains technical documentation based on standard operating procedures. Partners with various teams to analyze customer specific requirements and configuration and translate those into technical design specification and data flow from which programs are developed and coded. Actively participates in and contributes to daily communications, team meetings and project/issue resolution. Responsible for accurate management of plan benefits coding changes, test execution and validation efforts of plan benefit design requests. Maintains customer documentation that validates configuration. Efficiently and effectively distributes tasks, using clear and concise instructions and expectations. Completes deliverables independently and within an agile team setting. Other duties as assigned.

  • Ensure a high level of quality and accuracy through benefit configuration, test execution and validation efforts.
  • Serve as a subject matter expert on benefits and claim adjudication system coding setup.
  • Analyze new business requirements for benefit design changes.
  • Comply with standards regarding benefit design and configuration.
  • Maintain technical documentation based on standard operating procedures.
  • Partner with various teams to analyze customer specific requirements and configuration.
  • Translate customer requirements into technical design specifications and data flow.
  • Participate in daily communications, team meetings, and project/issue resolution.
  • Manage plan benefits coding changes and validation efforts.
  • Maintain customer documentation that validates configuration.
  • Distribute tasks efficiently and effectively with clear instructions.
  • Complete deliverables independently and within an agile team setting.
  • Up to 2 years of experience in benefit plan configuration/analysis.
  • Experience with adjudication processes (FirstRx preferred).
  • Strong attention to detail, critical thinking and analytical skills.
  • Strong working knowledge of Microsoft Office suite, specifically Word and Excel.
  • Ability to work within a team and as an individual contributor in a fast-paced environment.
  • Ability to identify and resolve process and/or systems issues.
  • Strong sense of urgency leading to timely completion of projects.
  • Bachelor's degree or a combination of education and work experience.
  • Comprehensive benefits package including health, life, and voluntary benefits.
  • Short-term incentives.
  • Opportunities for professional growth and development.
  • Rewards and recognition programs.
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