HealthRules Lead Implementation
- Citiustech
- 10 - 15 years
- Pune
- 6 months ago
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Job Description
Job Role: Presales Analyst/Senior Presales Analyst
Location: Bangalore, Mumbai, Pune, Chennai, Hyderabad
Work Mode: Hybrid
Experience: 4 to 7 years
Skill: Presales, Healthcare Domain, Sales, Marketing
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.
Job Classification
Industry: IT Services & ConsultingFunctional Area / Department: Healthcare & Life SciencesRole Category: Healthcare & Life Sciences - OtherRole: Healthcare & Life Sciences - OtherEmployement Type: Full timeContact Details:
Company: CitiustechLocation(s): Pune
Keyskills: HealthRules Product Implementation Healthedage HealthRules payer HealthRules Designer healthedge
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