Capitation Configuration Analyst @ Dexian | Jobright.ai
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Capitation Configuration Analyst jobs in Eden Prairie, MN
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Dexian · 5 hours ago

Capitation Configuration Analyst

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ConsultingHuman Resources

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Responsibilities

Reading and interpreting provider contracts, or other pricing artifacts, to complete provider configuration design templates
Creating standard NetworX templates within Facets and on paper as a guide for Config Analysts to use to configure new
Extracting and analyzing pricing data to help assess business processes such as configuration accuracy, capitation allocation payments, and to resolve provider pricing inquiries and/or pended claims
Complete quality control measures, to include claim modeling, to ensure accuracy of NetworX Agreement configuration.
Identify process improvement opportunities to improve accuracy and timeliness (i.e., automation, turn-around time, etc.)
Manage assigned inventory to ensure timely contract load
Perform user acceptance testing on new/changed pricing tools
Serve as subject matter expert regarding configuration and/or Facets capabilities
Provide direction in selecting the appropriate Configuration Template(s) and/or request new designs for new pricing requirements

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Provider Pricing ConfigurationFacetsNetworXReading provider contractsContract reimbursement methodologyMicrosoft WordMicrosoft ExcelMicrosoft OutlookMicrosoft SharePointCapitation experienceDOFR / FARM applicationsMedicare pricing experienceMedicaid pricing experienceCommercial pricing experienceCustomer focus

Required

High school diploma or GED
3 years of Provider Pricing Configuration in Facets/NetworX
3 years of experience reading, interpreting, and translating provider contracts for professional, facility and ancillary providers
3 years of physician, facility, and ancillary contract reimbursement methodology with Medicare & commercial products
Self-directed individual with a proven track record of strong organizational skills and ability to adapt quickly to change
Strong communication skills to translate complex or technical information clearly and concisely for diverse internal audiences
Proven ability to manage productivity and efficiency to visualize and achieve set goals for delivery of contracts for installation
Intermediate level of proficiency with Microsoft Word / Excel / Outlook / SharePoint
Strong customer focus with proven ability to anticipate, understand, and meet the needs of internal and external customers
Previous provider capitation experience

Preferred

Experience working with DOFR / FARM applications
Medicare, Medicaid & Commercial pricing experience
Undergraduate degree in business or healthcare

Company

Dexian provides services for staffing, talent development, and consulting, with a focus on technology, finance, and project management.

Funding

Current Stage
Late Stage

Leadership Team

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Mahfuz Ahmed
Founder & Chairman of the Board
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Company data provided by crunchbase
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