Configuration Business Analyst

We exist for workers and their employers -- who are the backbone of our economy.  That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.

Key Responsibilities:

• Platform and Configuration Support:

  • Serve as a subject matter expert (SME) for provider data and claims platforms.

  • Troubleshoot, analyze, and resolve issues related to platform functionality, system configuration, and performance.

  • Work with technical teams to identify and implement system enhancements, fixes, and updates to improve platform performance and meet business requirements.

  • Monitor and optimize system performance, proactively addressing issues to prevent disruptions in business operations.

• Business Analysis & Requirements Gathering:

  • Work closely with business users (Claims, PDM, IT, etc.) to gather and document system requirements, and translate them into actionable, functional specifications.

  • Conduct gap analyses to identify system inefficiencies and collaborate with the team to implement solutions that improve workflows and business processes.

  • Provide subject matter expertise on system configuration, ensuring new features and changes meet business needs.

• Data Integrity & Quality Assurance:

  • Ensure data accuracy, integrity, and consistency across systems, perform regular audit and validation checks to maintain high-quality data.

  • Develop and execute test plans to ensure system changes meet business needs and functional specifications.

  • Document system configurations, updates, and changes, ensuring that all processes are clearly outlined for internal use.

• Collaboration & Training:

  • Act as a liaison between technical teams and business users to ensure system solutions align with business goals and requirements.

  • Provide technical support and training for end-users on system functionality, process changes, and best practices.

  • Foster collaboration across departments to ensure platform systems are optimized to meet business needs.

• Project Management:

  • Support the planning, coordination, and execution of system upgrades, platform changes, and new implementations.

  • Manage system-related projects from initiation through to completion, ensuring timely delivery within scope and budget.

Qualifications:

• Education:

  • Bachelor's degree in a relevant field such as Healthcare, Business, Computer Science, or Mathematics.

• Experience:

  • 5+ years of experience working with core platform systems in a health plan, TPA, or healthcare-related setting.

  • Experience with Health Rules Payer preferred.

  • Experience with Provider Data profiles and network configuration.

  • Hands-on experience with health plan building, benefits configuration, and system administration in core platform systems.

  • Familiarity with healthcare operations, including claims adjudication, enrollment, and provider management processes.

• Skills & Competencies:

  • Advanced skills in data analysis tools like Excel, PowerPoint, SQL, and other related software applications

  • Strong analytical and problem-solving skills with the ability to translate business needs into system configurations and solutions.

  • Understanding of plan building, benefits configuration, and related system settings.

  • Experience with system integrations and interfacing with third-party vendors.

  • Knowledge of healthcare regulations and standards, including HIPAA, CMS, and ACA.

  • Proficient in project management and documentation tools (e.g., JIRA, Confluence, Microsoft Project).

  • Excellent communication skills, both written and verbal, with the ability to engage with both technical and non-technical stakeholders.

  • Detail-oriented with a strong focus on system optimization, data integrity, and process improvement.

  • Ability to manage multiple priorities and deadlines in a fast-paced environment.

Preferred Qualifications:

• Familiarity with business intelligence tools (e.g., Tableau, Power BI) for reporting and analysis.

• Certification in Business Analysis (CBAP, PMI-PBA) or IT systems management is a plus.

Location: