Managed Care Benefit Configuration Specialist

The Benefit Configuration Specialist will implement new client benefit setup and hierarchy based on the specific needs of the customer. Benefit setup based on plan design changes of existing customers. Configures all aspects of benefit plan per health plan utilizing the Financial Risk Matrix for major commercial, Medicare Advantage and Medicaid Health Plans. Create and maintain configuration templates when loading benefit information. Responsibilities may include: - Develop all hierarchy levels in managed care platform for customer setups and configuration - Review and verify client setup is accurately reflected in platform - Monitor as assigned all QA processes for benefit builds - Follow and adhere to all Policies and Procedures for the benefit workflow within the managed care platform - Support quality reviews and testing of all benefit setup prior to customer implementation and go-live date - Ensure health plan configuration within system templates, related plans and benefits are updated as needed as well as tested and audited if issues are found in Benefit Configuration - Partner with Compliance department to audit client setups and configuration post go-live - Resolve escalated and complex processing, change requests, issues or questions