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HealthRules Lead Implementation

10 - 15 years

20 - 35 Lacs

Posted:1 hour ago| Platform: Naukri logo

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Work Mode

Hybrid

Job Type

Full Time

Job Description

Job Role:

Location:

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Job Overview:

As an HRP Sr Configuration Analyst/Specialist, you must be highly organized and detail-oriented, with strong analytical, problem solving, and prioritization skills. Proficiency in configuring and maintaining HealthRules Payor, a leading healthcare claims management system, is essential, and familiarity with data analytics tools is highly valued


Role & responsibilities:

  • Expertise in Healthedage platform with knowledge on configuring benefit plan using HealthRules Payer designer
  • Knowledge on using wizards and template for plan creation.
  • Good knowledge on US health care and payor business functions
  • Perform configuration of product, service categories, value list, BPC, Benefit plan.
  • Perform configuration of Network, Supplier Contract, Fee Components, Fee Schedule,
  • Knowledge of defining and using slots, riders, and templates in HRP
  • Should be able perform due diligence in understanding client current system and creating benefit plans based on benefit plan document.

Preferred candidate profile/skill:

  • HealthRules payor, HealthRules Designer
  • Benefit Plan configuration and Supplier Contract Configuration
  • Understanding of Benefit Terminologies: Copay, Coinsurance, Deductible, Limits, and Pre-auth etc.
  • Knowledge of different lines of business e.g. Commercial, Medicare, Medicaid, ASO, HIX, and Fully Insured, etc.
  • Knowledge of supplier contracting terms e.g. Per Diem, Per Case, APC pricing, DRG pricing, fee schedules, etc.
  • Excellent verbal and written communication and interpersonal skills.

Good to have skills:

  • HealthRules Payer hands on experience Life at CitiusTech

About us:

At CitiusTech, we constantly strive to solve the industry's greatest challenges with technology, creativity, and agility. With over 8,500 healthcare technology professionals worldwide, CitiusTech powers healthcare digital innovation, business transformation, and industry-wide convergence for over 140 organizations through next-generation technologies, solutions, and products. We aim to accelerate the transition to a human-first, sustainable, and digital healthcare ecosystem with the world's leading Healthcare and life sciences organizations and our partners. Here is an opportunity for you to make a difference and collaborate with global leaders to shape the future of healthcare and positively impact human lives.

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Citiustech
Citiustech

IT Services and IT Consulting

Princeton NJ

5001-10000 Employees

17 Jobs

    Key People

  • Ranjit Kumar

    CEO
  • Suresh Bandi

    COO

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