Join Our Team: Do Meaningful Work and Improve People's Lives
Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we're creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!
The Sr. Product Configuration Analyst is responsible to build and configure group product selections within the appropriate systems. They provide solutions for standard and non-standard benefit configuration as well as implementation for standard and non-standard product selections by Small, Mid-Market and Large employer groups and the Individual Market. They are required to develop a thorough understanding of the benefit selection from Sales and then apply that to the configuration of the system's product components such as the administrative rules, EOB rules, claims processing rules, provider network identification, utilization management rules and detailed benefit administration rules. Accurate and timely configuration of benefits is the key component in ensuring that customers can access their benefits including customer service, pharmacy and claims processing.
What you'll do:
* Utilize source documents to analyze and then configure standard and non-standard products and benefit provisions for Small, Mid-Market and Large employer groups and the Individual Market.
* Analyze and interpret the product selection and product changes, determine the gap between standard and custom benefits, consider system constraints and propose alternate solutions. Identify clarifications needed and inconsistent or incomplete product documents and gather information needed to ensure appropriate configuration of those elements.
* Configure the product "shell", product components, benefit summary details, accumulators, and existing language for the benefit quoting tool to ensure the timely generation of ID cards, payment of medical, dental, and pharmacy claims, and tools for quoting benefits on multiple platforms (customer service, on-line portals, etc.).
* Work with sales and operations to identify appropriate application of system restraints and considerations and request clarifications on product intent when needed.
* Analyze system generated reports to identify appropriate configuration updates.
* Provide timely and consistent status updates to all stakeholders and workgroups to ensure a smooth and efficient process for new and renewing groups. Participate in group implementation meetings to identify changes and provide knowledge for current product configuration.
* Provide support and analysis to retro-product updates and to ensure timely completion and movement into production.
* Research and respond to inquiries from other departments regarding benefit administration.
* Participate in project work and other duties on behalf of Product Configuration.
What you'll bring:
* Associate's degree in a related field such as Information Systems, Business Administration, or two (2) years' professional work experience.
* Three (3) years work experience in claims, customer service, membership and billing, quality audit, product configuration or similar area.
* Experience or training using Premera systems or equivalent.
* Good working knowledge of health insurance products, provisions and terminology.
* Advanced experience in Excel and Access.
* Ability to apply sound judgment, creative thinking and problem-solving skills, prioritize multiple-tasks simultaneously based on deadlines and urgency, and take initiative to perform work.
* Ability to work in a production environment where the work volume significantly increases in response to the rhythm of the business.
* Ability to communicate both verbally and in writing in a professional manner.
* Ability to work independently as well as collaboratively
* Strong attention to detail with outstanding proofreading skills and ability to analyze and understand detailed written and numerical data.
What we offer
* Medical, vision and dental coverage
* Life and disability insurance
* Retirement programs (401K employer match and pension plan)
* Wellness incentives, onsite services, a discount program and more
* Tuition assistance for undergraduate and graduate degrees
* Generous Paid Time Off to reenergize
* Free parking
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at email@example.com or via phone at 425-918-4785.