Plan Build Coordinator

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

📋 Description

• Develop, configure, and sustain healthcare plan designs and benefit structures across various systems.

• Ensure that plan configurations facilitate auto adjudication and adhere to regulatory and compliance standards.

• Review and revise plan configurations in response to updates in healthcare policies and regulations.

• Oversee the integration and interoperability of healthcare systems to enhance auto adjudication processes.

• Facilitate system upgrades, patches, and maintenance activities.

• Collaborate with IT and other departments to implement technological advancements and improvements.

• Test plan configurations to ensure accuracy and efficiency in claims adjudication.

• Identify and address discrepancies and issues related to adjudication.

• Create and document testing protocols and procedures.

• Gather requirements from both internal and external stakeholders, ensuring configurations align with organizational and client needs.

• Act as a subject matter expert in plan development and system configuration.

• Communicate project status, challenges, and resolutions to stakeholders effectively.

• Maintain thorough documentation of plan configurations, system modifications, and testing procedures.

• Utilize data and analytics to pinpoint trends and opportunities for improvement.

⛳️ Requirements

• Associate’s degree in healthcare administration, information systems, or a related discipline.

• A minimum of 2 years of experience in plan development, system configuration, and claims adjudication within the healthcare sector.

• Strong understanding of healthcare policies, regulations, and compliance requirements.

• Proficient in healthcare management systems and associated software.

• Exceptional problem-solving abilities and keen attention to detail.

• Strong communication and interpersonal skills.

• Capacity to thrive in a fast-paced environment while managing multiple projects concurrently.

• Experience with auto adjudication systems and technologies is preferred.

• Certification in healthcare information systems or related fields is preferred.

• Proven history of successful system integration and optimization projects is preferred.

🏝️ Benefits

• Comprehensive medical, dental, vision, and life insurance coverage.

• 401(k) retirement plan with employer matching contributions.

• Health Savings Account (HSA) and Flexible Spending Accounts (FSAs).

• Paid time off (PTO) and disability leave.

• Employee Assistance Program (EAP).

• Certain positions may qualify for additional compensation, including bonuses and merit increases.

• Individual compensation will be commensurate with experience and qualifications.