Benefits Configuration Analyst

This is a fully remote position, open to applicants in Alabama, +46 more states.

📋 Description

• Collaborate with clients to identify and understand requirements for benefit plans.

• Develop and maintain pharmacy benefit plans tailored for client groups.

• Organize the configuration and structure of benefits for assigned accounts.

• Ensure the integrity of plan data is monitored.

• Assist in initiatives aimed at process improvement.

• Manage prior authorizations and step therapy protocols.

• Transition new clients and update formularies as directed by the clinical team.

• Communicate project statuses and escalate issues as necessary.

• Provide insights to enhance workflow efficiency.

• Work closely with member support and customer success teams to address benefits inquiries.

• Offer troubleshooting assistance for claims adjudication.

• Facilitate implementations for new clients.

• Conduct testing during go-live phases and perform post-go-live audits.

• Support verification of plan accuracy.

⛳️ Requirements

• Minimum of 4 years of experience in payer/claims and benefit configuration is required.

• Strong analytical skills.

• Proficient in Microsoft Excel.

• Excellent communication skills, both in face-to-face meetings, conference calls, and written correspondence.

• Self-motivated with the ability to make informed decisions and adopt creative solutions to complex challenges.

• Solutions-oriented with a focus on problem-solving and efficiency.

• Must be flexible, reliable, and adaptable, capable of performing well under pressure in a fast-paced technology environment.

🏝️ Benefits

• Medical, Pharmacy, Dental, Vision, Life Insurance, and AD&D Insurance.

• Flexible Spending Benefits.

• 401(k) Retirement Savings Program.

• Short-term and long-term disability coverage.

• Discretionary Paid Time Off.

• Paid Company Holidays.

• Wellness Benefits.

• Commuter Benefits.

• Paid Parental Leave benefits.

• Employee Assistance Program (EAP).

• Well-stocked kitchen in office locations.

• Opportunities for professional development and training.

• Support for mental health.

• Potential bonuses, commissions, or equity options may be available.