Benefit Configuration Analyst
Is responsible for accurately analyzing new and changed benefit plans and completing a benefit structure for each. Ensures compliance with the Benefits Departments
policies and procedures. Ensures consistency among all plans when communicating benefit set up structures. Communicates plan benefits and changes effectively and acts as a point of contact for both internal and external customers.
- Analyzes new business plans and changes to existing business plans in order to establish the appropriate benefit structure needed. Working with the Implementation or Migration team to ensure a smooth implementation, meeting all agreed to deadlines.
- Works closely with the IT claims systems staff to develop product design & changes through enhancements, making certain that they are adequate to meet the claims processing needs. Also oversees the any configuration changes associated with the enhancements and the testing associated with these changes.
- Performs project analysis at a level to determine specific tasks which must be completed for a given project, such as system testing or benefit projects.
- Obtains and maintains an in-depth working knowledge of the claims system, the configuration and the claim data- base in order to extract data to perform updates to the data.
- Serves as the primary contact for both internal MBH customers and external customers regarding benefit plan configuration questions and issues.
- Provides training and acts as a first line of support to less experienced staff within the unit.
- Prepares updates/reports and documentation for SOX requirements as required.
Experience: 5 years of managed care experience with at least 3 yrs in a claims related field, IT experience preferred.
Computer Skills: Experience with MS Office and database tools, typing skills of 35 WPM.
Other: Ability to analyze benefit plans to demonstrate a benefit structure with an automated claims processing system, based on an understanding of the systems functionality and an understanding of business policies.
Ability to identify issues and bring them to resolution.
14100 Magellan Plaza (MO02)
14100 Magellan Plaza
Magellan Health Services is a leading specialty health care management organization with expertise in managing behavioral health, radiology and specialty pharmaceuticals, as well as public sector pharmacy benefits programs. We deliver innovative solutions to make a positive impact on the cost and quality of health care, keeping the best interests of the people we serve at the center of our decision-making. The breadth of our offerings, depth of expertise, clinical excellence and smart, talented employees is what makes us unique.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment where we value professional growth and development, total health and wellness, rewards and recognition and employee unity. Magellan is a place where you can thrive.
Magellan Health Services has charted its course to become one of the largest managed behavioral health care companies in the nation. The...