Senior Analyst, Authorization Services Design & Configuration

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

📋 Description

• Oversee the setup and upkeep of authorization workflows, rulesets, and automations within the UM platform.

• Convert business needs into exact technical specifications, ensuring that business rules and logic are accurately depicted, tested, and executed.

• Examine and resolve escalations by conducting root-cause analysis of system behavior and identifying configuration gaps.

• Recognize friction points in the authorization process and document potential improvements and automation opportunities.

• Act as the primary subject matter expert for the UM system, providing education to Product, Clinical, and Regulatory teams.

• Create testing protocols and execute test scenarios to confirm system behavior and ensure configuration accuracy.

• Direct corrective actions when system performance deviates from anticipated results.

• Manage assigned caseloads and project tasks through effective dashboard management and prioritization.

• Keep documentation updated for business rules, technical specifications, and workflow designs.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• A minimum of 2 years of experience in system configuration, business rules management, or technical workflow design.

• At least 2 years of experience in a technical or operational role involving root-cause analysis and data troubleshooting.

• Intermediate to advanced proficiency in Excel/Google Sheets, including vlookups, pivot tables, and data manipulation skills.

• Experience in evaluating and understanding end-to-end process impacts in complex technical settings.

• Excellent communication skills with the capability to articulate technical system logic to non-technical stakeholders.

• Over 1 year of working knowledge within the healthcare sector (either payer or provider).

• Previous experience in Prior Authorizations or Insurance Operations.

• At least 2 years of proficiency in SQL, BigQuery, or comparable database languages.

• Familiarity with project management and communication tools such as JIRA, Linear, and Slack.

• Experience in handling large datasets, including data verification and management.

🏝️ Benefits

• Comprehensive employee benefits.

• Unlimited vacation program.

• Annual performance bonuses.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 11 paid holidays.

• Paid sick time.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life and disability insurance.

• Paid wellness time and reimbursements.