Benefits Configuration Analyst

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with clients to identify and comprehend benefit plan requirements. Develop and sustain pharmacy benefit plans for client groups.

• Assist in organizing the benefit configuration and structure for assigned accounts by overseeing plan data integrity.

• Contribute to identifying areas for process improvement.

• Manage prior authorizations and step therapy protocols.

• Transition new clients and revise formularies with updates as directed by the clinical team.

• Communicate project status and escalate issues when necessary. Offer insights to enhance workflow efficiency.

• Work alongside member support and customer success teams to promptly address inquiries related to benefits, enhancing the member experience.

• Provide troubleshooting assistance for our claims adjudication process.

• Support the implementation of new clients, conduct go-live testing, and perform post-go-live audits to ensure accurate configuration of plans.

⛳️ Requirements

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

• Proficient analytical skills; strong knowledge of Microsoft Excel.

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

• Self-motivated with the capability to make informed decisions, devise innovative solutions to complex challenges, and fulfill commitments.

• Execution-oriented mindset - a solutions-focused problem solver driven by efficiency.

• Adaptable, reliable, and capable of performing under the pressures of a fast-paced technology environment.

🏝️ Benefits

• Comprehensive wellness benefits including Medical, Pharmacy, Dental, Vision, and Life insurance.

• Flexible Spending Benefits.

• Discretionary Time Off.

• 401(k) Retirement Savings Program.

• Paid Parental Leave benefits.

• Opportunities for professional development and training.