Your Role

The Pricing Analytics and Contract Configuration Agreement Maintenance team broadcasts items into the production environment, crosswalk to Provider profiles to have accurate pricing applied to applicable lines of business, and auditing pricing attached correctly in production to the Providers and rosters. The Fee schedule work is quarterly updates, annual updates and custom fee schedules that can from a Contract, Retro Tracking, Medicare updates, Optum updates, Medi-Cal audit and review, and Medical Informatics that comes in as needed. The Configuration Analyst Experienced will report to the Senior Product Manager. In this role you will Assist with providing the necessary updates and/or auditing for accurate pricing for the Provider files. This will support with getting files updated in a timely manner to avoid interest for claims and meeting our deadlines. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• Analyze medium to hard customers' business requirements and software/product objectives and perform system configuration analysis, design, coding, and unit testing following established processes, standards and procedures
• Develop prototype configuration to support solution selection and develop documented solutions and processes using appropriate documentation protocols
• Resolve escalated issues in the appropriate manner and appropriate timeframe, to meet client specific SLAs
• Identify gaps between external expectations and system limitations and suggest configuration improvements or streamlined maintenance processes and techniques
• Act as the liaison between IT and business areas in support of extensions and service packs
• Audit and identify potential data anomalies

Your Knowledge and Experience

• Requires a bachelor's degree in Health Care Management, Computer Science, or a related discipline (or an equivalent combination of education and work experience may be taken into consideration in lieu of a degree)
• Requires at least 1 year of experience in a configuration analyst role, configuring health plan business applications
• Requires at least 3 years performing complex business analysis and/or technology healthcare operations
• Knowledge of FACETS, CLMS, MS Office Suite
• Previous auditing experience and claims processing experience in a health plan
• Service (internal customers) oriented/philosophy in a diverse, demanding, and evolving environment with good analytical and problem-solving skills, time management and organizational skills
• Excellent interpersonal skills and ability to act as a team player

Pay Range:

The pay range for this role is: $ 66770.00 to $ 93390.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.