Job Description

Healthcare Claims & Benefits Configuration Analyst (Facets)

Location: 4000 Luxottica Place, Mason, OH 45040 (Hybrid 2 days per week onsite)

Duration: 3 Months with possible extension

Work Hours: 8 AM to 5 PM EST (1-hour break; 40 hours/week)

Pay Rate: $50-55/hr. W2 All Inclusive

Role Overview

Serve as a Sr. Configuration Analyst on the Business Configuration Solutions team. Responsible for the enablement of member benefit configuration strategies by designing, implementing, and executing configuration. Lead projects for the Configuration space to enable system and process solutions for Business Configuration tool sets.

Key Responsibilities

• Serve as a subject matter expert for the Business Configuration team supporting EyeMed's cross-functional teams to implement client requirements.
• Lead/represent cross-functional meetings and capture business requirements.
• Serve as a subject matter expert representing the Configuration workstream for large Government Implementations for Medicaid, Med/Surgical, and Medicare programs .
• Provide data analysis and troubleshooting expertise on configuration tool sets with automated processes .
• Prepare data for analysis by removing duplicates, errors, and outliers; perform data validation .
• Build SQL queries to pull backend data based on configuration needs.
• Serve as a Business Analyst documenting requirements, process flows , and executing testing for enhancements to improve the automation toolset.
• Perform Fit/Gap Analysis and feedback assessments for new client plans.
• Collaborate with leadership on configuration roadmap deliverables and automation of EyeMed's product and network offerings.
• Self-manage and prioritize to meet SLAs and KPIs.
• Build and maintain strong stakeholder relationships across EyeMed.

Must-Have Qualifications

• Facets experience
• SQL/Database expertise
• Healthcare claims understanding and benefit configuration
• Analytical & problem-solving capability
• Experience with Oracle SQL for data validation and Facets for claims testing
• Experience in Medicaid product configuration
• Windows OS proficiency
• Exposure to Informatica -based automation tools (EyeMed homegrown tool)

Preferred Qualifications

• 5+ years experience with Facets platform
• Experience with Medical Plan Benefit Configuration
• Provider Network & Agreement Configuration
• Knowledge of Medicare/Medicaid
• Excellent communication and interpersonal skills
• Fast learner with strong analytical skills

Education

• Bachelor's degree or equivalent work experience

CANDIDATE SELF-ASSESSMENT: SKILL QUALIFICATION MATRIX

Please fill out the below matrix while applying. Use a scale of 1 (Beginner) to 10 (Expert) for the Self-Rating column.

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