Health Rules Configuration Analyst

Location: Remote (USA)
Hire Type: Contract (C2C)
Rate: Open

Position Summary

We are seeking an experienced Health Rules Configuration Analyst with strong expertise in the HealthRules Payor platform. The ideal candidate will have hands-on experience in healthcare payer benefit configuration, referral authorization setup, and strong knowledge of HealthRules Payor database structures and SQL querying.

This role requires a detail-oriented professional capable of supporting healthcare payer operations through accurate configuration, troubleshooting, and system optimization.

Required Skills & Experience

  • Minimum 3+ years of hands-on experience in:
    • HealthRules Payor benefit configuration
    • Referral category configuration within HealthRules Payor
    • Authorization and benefit setup in payer systems
  • Strong expertise in:
    • HealthRules Payor configuration and administration
    • Healthcare payer workflows and claims processing concepts
    • Benefit plan and authorization rule configuration
  • Advanced understanding of:
    • HealthRules Payor table structures
    • Database relationships and configuration dependencies
  • Ability to:
    • Write and execute SQL queries against HealthRules Payor tables
    • Analyze configuration issues and support troubleshooting activities
    • Validate system configurations and perform impact analysis

Key Responsibilities

  • Configure and maintain benefits, referrals, and authorization rules in HealthRules Payor
  • Support payer operations through accurate system configuration and testing
  • Develop and execute SQL queries for data validation, troubleshooting, and reporting
  • Analyze business requirements and translate them into system configurations
  • Collaborate with business analysts, developers, QA teams, and stakeholders
  • Perform configuration testing and support defect resolution
  • Ensure compliance with healthcare payer policies and operational standards
  • Maintain documentation for configurations, workflows, and change management

Preferred Qualifications

  • Experience working with healthcare payers or managed care organizations
  • Knowledge of claims adjudication and authorization workflows
  • Familiarity with healthcare domains such as:
    • Benefits administration
    • Referrals and prior authorization
    • Provider and member configuration
  • Strong analytical and communication skills
  • Ability to work independently in a remote environment

Employment Details

  • Work Location: Remote
  • Employment Type: Contract (C2C)
  • Compensation: Open / Negotiable based on experience

Job Information

  • Employment Type

    Contract

  • Contract

    Not Mentioned

  • Salary

    As Per Industry Standards.