Join NTT DATA and contribute to innovative solutions in healthcare operations. This role focuses on optimizing provider pricing configuration for a leading healthcare client, ensuring efficient claims processing and enhanced member satisfaction.

This position is integral to our Business Process Outsourcing (BPO) team, aimed at improving productivity, turnaround time, and quality within the healthcare configuration domain. Your work will directly support our client's mission to provide high-quality healthcare and health solutions.

Key responsibilities include configuring client systems for pricing and provider contracts according to defined business rules for a new claims processing platform. You will evaluate configuration requirements, formulate approaches, and implement advanced functionalities based on best practices.

Further duties involve creating rules based on gathered business requirements, troubleshooting Health Plan benefits, provider, pricing, and system issues. This role also entails performing production support, updating configurations within the core claims processing system, supporting fee schedule changes, and managing Master Issue Logs for critical change requests. You will also conduct data validation and audits of existing plans and contracts.

Ideal candidates possess over 5 years of experience in the US healthcare claims payer industry, with a strong focus on configuring client systems for pricing (provider contracts) and conducting UAT testing.

A High School diploma or equivalent is mandatory, with an Associate's degree, technical college coursework, or some college education being preferred. The ability to thrive in a project-oriented environment is essential. Experience with SQL for query writing (2+ years) and exposure to VB/Vb.net are considered advantageous.