Health Plan Configuration Analyst

Job Summary :

We are looking for a skilled HealthRules Payor Configuration Specialist to design, develop, configure, and test HealthRules Payor configurations, Including benefits, products, and policies. The ideal candidate will support changes in benefits, policies, and procedures, ensuring timely maintenance and updates of configurations.

This role requires strong analytical skills, attention to detail, and effective communication with both technical and non-technical audiences.

Key Responsibilities :

Possess knowledge in benefits, including benefit plans (with all cost-sharing information), templates, products, and accounts. Gather requirements, design documents, configure settings, and perform different types of testing (Dental, QA, and Regression) in HealthRules.

Analyze, configure, and test to maintain HealthRules Payor, supporting changes in benefits, contracts, and procedures.

Work with the HealthRules Payor (HRP) application, specifically Designer and Manager.

Hands on work experience with Test Runner tool for creating UTC’s and then evaluating the test results.

Understand and analyze healthcare eligibility and claims data flow within HealthRules. Understand scenarios and write HRL (HealthRules Language) in HealthRules Payor applications.

Perform full, unit, and regression testing. Create demo documents to capture before and after configuration updates.

Communicate clearly and effectively with diverse audiences, including technical and non-technical personnel.

Skills / Experience :

Strong analytical and problem-solving skills.

Excellent communication skills. Ability to work independently and as part of a team.

Attention to detail and strong organizational skills.

Basic knowledge of databases and SQL.

Candidate Profile :

Education / Qualification : Any Graduate Work Experience

Work Experience : 5-8 years of experience in US health insurance benefit configuration and testing. At least 3 years of experience working with HRP applications.

Functional Skills : US Healthcare Benefits and Pricing configuration and testing. Location – PAN India

Shift : 5PM - 2AM