Blue Shield of CA
Configuration Analyst, Associate
Blue Shield of CA, San Diego, California, United States, 92189
Your Role
The Pricing Analytics and Contract Configuration team is responsible for configuring systems to pay per negotiated provider contracts. The Configuration Analyst, Associate will report to the Pricing Analytics Contract Configuration Manager. In this role you will conduct build activity, run test claims to ensure future claims will be paying correctly based on the contractual terms. You will validate that the negotiated provider contracts were built correctly and according to the contract's specification. You will support process improvements by identifying possible gaps and addressing remediations.
Your Work
In this role, you will:
Analyze contract language to translate into specific pricing configuration with guidanceDevelop simple configuration approaches to support solution selection and develop documentation outlining the approach using appropriate documentation protocolsBe accountable for at least one contract type of configuration and testing of the assigned contractsDevelop and execute claims tests to support the testing terms and services for the negotiated contractsWork directly with Provider Contracting partners for clarifications when contract language may be unclearAnalyze the provider contracts to ensure accuracy in the way it was builtService internal customers with an oriented philosophy and work in a diverse, demanding and evolving environment where strong analytical, problem-solving skills, time management and organizational skills are required
Your Knowledge and Experience
Requires a bachelor's degree or equivalent experience0-2 years of prior relevant experienceStrong Claims knowledge and experience highly preferredKnowledge of FACETS, CLMS, MS Office Suite preferredPrevious auditing experience and claims processing experience in a health plan preferredStrong analytical, problem-solving skills, time management and organizational skillsExcellent interpersonal skills and ability to act as a team player
Pay Range:
The pay range for this role is: $26.20 to $36.68 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.
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The Pricing Analytics and Contract Configuration team is responsible for configuring systems to pay per negotiated provider contracts. The Configuration Analyst, Associate will report to the Pricing Analytics Contract Configuration Manager. In this role you will conduct build activity, run test claims to ensure future claims will be paying correctly based on the contractual terms. You will validate that the negotiated provider contracts were built correctly and according to the contract's specification. You will support process improvements by identifying possible gaps and addressing remediations.
Your Work
In this role, you will:
Analyze contract language to translate into specific pricing configuration with guidanceDevelop simple configuration approaches to support solution selection and develop documentation outlining the approach using appropriate documentation protocolsBe accountable for at least one contract type of configuration and testing of the assigned contractsDevelop and execute claims tests to support the testing terms and services for the negotiated contractsWork directly with Provider Contracting partners for clarifications when contract language may be unclearAnalyze the provider contracts to ensure accuracy in the way it was builtService internal customers with an oriented philosophy and work in a diverse, demanding and evolving environment where strong analytical, problem-solving skills, time management and organizational skills are required
Your Knowledge and Experience
Requires a bachelor's degree or equivalent experience0-2 years of prior relevant experienceStrong Claims knowledge and experience highly preferredKnowledge of FACETS, CLMS, MS Office Suite preferredPrevious auditing experience and claims processing experience in a health plan preferredStrong analytical, problem-solving skills, time management and organizational skillsExcellent interpersonal skills and ability to act as a team player
Pay Range:
The pay range for this role is: $26.20 to $36.68 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.
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