Source Job

• Develop, configure, and maintain healthcare plan designs and benefit configurations in various systems.
• Perform comprehensive testing of plan configurations to ensure accurate and efficient claims adjudication.
• Work closely with internal and external stakeholders to gather requirements and ensure plan configurations meet organizational and client needs.

Point C is a national third-party administrator (TPA) that delivers customized self-funded benefit programs. We are a mission-driven company with a focus on innovative cost containment strategies.

• Analyze benefit plan documents to build benefit categories and adjudication rules for claims processing.
• Review member accumulators and assist in loading benefit logic to member and group records.
• Manage daily configuration inventory queues and support cross-functional teams during implementations and renewals.

Gravie creates health benefits that actually benefit small and midsize businesses and their employees. They are well capitalized, have top-tier investors, and a diverse, non-hierarchical, merit-driven culture that values authenticity and high performance.

• Design and configure prior authorization criteria, decision trees, and authorization parameters within the PA system.
• Perform quality assurance and quality control reviews to ensure clinical intent and regulatory compliance.
• Collaborate with internal teams and external clients to support delegated PA services and system optimization.

Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans. The company is a public benefit corporation focused on rebuilding trust in healthcare in the U.S., with a culture that emphasizes collaboration and client support.