Configuration Analyst remote jobs - 1,259 jobs

A leading analytics firm is seeking a Finance Associate to support analytical and operational finance work. This remote independent contractor role requires the review of financial datasets, assisting with model updates, and producing structured summaries. Ideal candidates will have strong analytical and spreadsheet skills and experience in finance or business operations. The position offers a flexible workflow with compensation of $45 to $90 per hour. #J-18808-Ljbffr

A cutting-edge data analytics firm located in San Francisco is looking for a customer-focused Data Analyst. In this role, you will partner with clients to answer critical business questions regarding revenue performance and marketing optimization. The ideal candidate will possess strong analytical thinking skills and be able to communicate insights effectively. This position offers both in-person and flexible remote options, with a competitive salary range between $40,000 to $120,000 USD depending on experience and qualifications. #J-18808-Ljbffr

A leading DeFi firm is seeking a candidate for a key role in quantitative research and protocol partnerships. This position involves evaluating yield strategies, conducting risk assessments, and developing competitive analytics. Ideal candidates will have experience in crypto-native environments, fluency with on-chain data tools, and a strong interest in DeFi innovation. This role offers remote work within the US and competitive compensation packages. #J-18808-Ljbffr

A leading healthcare technology company is seeking a Data Scientist in San Francisco to optimize AI products and create analytics for medical professionals. Candidates should have over 5 years of experience and advanced knowledge in statistical concepts and machine learning. This role offers a competitive salary between $170,000 and $248,000, plus comprehensive benefits including health offerings and wellness programs. Join us to make an impact in the healthcare industry. #J-18808-Ljbffr

Select how often (in days) to receive an alert: Lead Cyber Watch Ops Analyst - 90402954 - null Your success is a train ride away! As we move America's workforce toward the future, Amtrak connects businesses and communities across the country. We employ more than 20,000 diverse, energetic professionals in a variety of career fields throughout the United States. The safety of our passengers, our employees, the public and our operating environment is our priority, and the success of our railroad is due to our employees. Are you ready to join our team? Our values of ‘Do the Right Thing, Excel Together and Put Customers First' are at the heart of what matters most to us, and our Core Capabilities, ‘Building Trust, Accountability, Effective Communication, Customer Focus, and Proactive Safety & Security' are what every employee needs to know and do to be most impactful at Amtrak. By living the Amtrak values, focusing on our capabilities, and actively embracing and fostering diverse ideas, backgrounds, and perspectives, together we will honor our past and make Amtrak a company of the future. SUMMARY The Cyber Watch Operations Analyst is a key position responsible for supporting the day-to-day operations of our Cyber Threat Command Center. In this role, you will have a critical impact with key stakeholder engagement, cybersecurity incident management, incident response, and coordination. Your expertise in cyber incident response, cybersecurity incident handling, and cyber threat analysis will be instrumental in protecting our organization's systems, data, and reputation. ESSENTIAL FUNCTIONS Ability to work under pressure, prioritize tasks, and meet deadlines in a fast-paced environment. Ability to think critically and like threat actors. Strong analytical and problem-solving skills, with the ability to assess complex situations and make informed decisions. Ability to communicate complex information, concepts, or ideas in a confident and well-organized manner through verbal, written, and/or visual means. Ability to apply techniques for detecting host and network-based intrusions using intrusion detection technologies. Ability to interpret the information collected by security tools. Knowledge of attack vectors, threat tactics, and attacker techniques. Preferred ability for effective communication and interpersonal skills, work well with others in an integrated team environment, and must be self‑motivated. Preferred knowledge and familiarity with Operational Technology (OT), Industrial Controls Systems (ICS) or Supervisory Control and Data Acquisition (SCADA) systems but not required. Responsible for delivery of security solutions for activity‑based assignments, executing and resolving problems within specified area. Monitor Cyber security anomalies, investigate, resolve and escalating Cyber Security events, incidents and problems. Search for potential vulnerability, exploit, or “0” day based on user behavior, endpoint threat detection, network behavior analytics, artificial engine alarms and managed security reports. Review Firewall, IDS/IPS logs, web content filtering logs, NetFlow device logs, antivirus logs. Lead Cyber Security tools (SIEM, EDR, CASB etc.) administration. Lead periodical checks for company policy violation / Support the investigation on policy violation. Lead Cyber security audits and inspecting security logs to uncover possible security violations. Generating, gathering, and tracking security metrics, developing scorecards for the metrics, and communicating the results. Supports and participates in formal reporting related to Cyber Security Operations. Monitor security events and develop Cyber security controls across the enterprise. Lead Security support efforts for application and infrastructure related projects. Lead application security risk assessments for new or updated internal or third‑party applications. Conduct quality test activities and validate test completeness in preparation for go‑live. Responding and resolving problems, security incidents and forensic investigations. Investigates, resolves and escalates problems. Monitors and analyzes metrics to ensure customer satisfaction and vendor performance. Lead vulnerability and risk analysis using commercial tools or custom scripts and documenting found gaps. MINIMUM QUALIFICATIONS Bachelor's degree in computer science, Information Systems, or related field plus 6+ years relevant experience required or 9+ years of relevant work experience required to satisfy education and experience requirements. Professional security‑related certifications (e.g., Security+, Certified Ethical Hacker (CEH), Certified Information Systems Security Professional (CISSP), etc.). Must possess excellent customer service, strong communication and interpersonal skills, work well with others in an integrated team environment, and must be self‑motivated. Strong analytical skills. Experience with SIEM, EDR, CASB, IDS/IPS, AV, DLP UEBA, FW, etc. technologies. Experience performing vulnerability management assessments. Experience working in a Cyber Security Operations (or SOC) as an analyst. PREFERRED QUALIFICATIONS Master's degree in information technology, Cyber Security, or equivalent. Experience with scripting languages. 8+ years' experience in cyber security specialization (compliance, information security program management, continuous monitoring, vulnerability assessment). WORK ENVIRONMENT Work is performed in a Remote Work Environment. May require travel up to 10% of the time. Requires on‑call status. After hours, weekend and periodic shift work may be required. COMMUNICATIONS AND INTERPERSONAL SKILLS Must have excellent oral and written communication skills. The salary/hourly range is $103,700-$134,460. Pay is based on several factors including but not limited to education, work experience, certifications, internal equity, etc. Depending on an employee's assigned worksite or location, Amtrak may consider a geo‑pay differential to be applied to the employee's base salary. Amtrak may offer additional incentive and pay programs to recognize and reward our employees, including a short‑term incentive bonus based on factors such as individual and company performance that is commensurate with the level of the position and/or long‑term incentive plan compensation. In addition to your salary, Amtrak offers a comprehensive benefit package that includes health, dental, and vision plans; health savings accounts; wellness programs; flexible spending accounts; 401(k) retirement plan with employer match; life insurance; short and long‑term disability insurance; paid time off; backup care; adoption assistance; surrogacy assistance; reimbursement of education expenses; Public Service Loan Forgiveness eligibility; Railroad Retirement sickness and retirement benefits; and rail pass privileges. Learn more about our benefits offerings here. Requisition ID: 165673 Work Arrangement: 02-Remote Optional Click here for more information about work arrangements at Amtrak. Relocation Offered: No Travel Requirements: Up to 25% You power our progress through your performance. We want your work at Amtrak to be more than a job. We want your career at Amtrak to be a fulfilling experience where you find challenging work, rewarding opportunities, respect among colleagues, and attractive compensation. Amtrak maintains a culture that values high performance and recognizes individual employee contributions. Amtrak is committed to a safe workplace free of drugs and alcohol. All Amtrak positions require a pre‑employment background check that includes prior employment verification, a criminal history check and a pre‑employment drug screen. Candidates who test positive for marijuana will be disqualified, regardless of any state or local statute, ordinance, regulation, or other law that legalizes or decriminalizes the use or possession of marijuana, whether for medical, recreational, or other use. Amtrak's pre‑employment drug testing program is administered in accordance with DOT regulations and applicable law. In accordance with DOT regulations (49 CFR § 40.25), Amtrak is required to obtain prior drug and alcohol testing records for applicants/employees intending to perform safety‑sensitive duties for covered Department of Transportation positions. If an applicant/employee refuses to provide written consent for Amtrak to obtain these records, the individual will not be permitted to perform safety‑sensitive functions. In accordance with federal law governing security checks of covered individuals for providers of public transportation (Title 6 U.S.C. §1143), Amtrak is required to screen applicants for any permanent or interim disqualifying criminal offenses. Note that any education requirement listed above may be deemed satisfied if you have an equivalent combination of education, training and experience. Amtrak is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race/color, to include traits historically associated with race, including but not limited to, hair texture and hairstyles such as braids, locks and twists, religion, sex (including pregnancy, childbirth and related conditions, such as lactation), national origin/ethnicity, disability (intellectual, mental and physical), veteran status, marital status, ancestry, sexual orientation, gender identity and gender expression, genetic information, citizenship or any other personal characteristics protected by law. #J-18808-Ljbffr

We are looking for a Lead Clinical Configuration Analyst to play a key role in the technical configuration of platform requirements for Cohere's Platform-as-a-Service (PaaS) clients. Reporting into our Senior Manager, PaaS Value Delivery, you will be part of a small, fast-paced team working directly with client-facing team members to understand and deliver key clinical configurations that are integral to helping new and existing clients meet their prior authorization automation goals. Ultimately, the work you do will have a direct impact on the growth of the company and our ability to assist more patients at a time in their healthcare journey when they need help most. What you'll do: Ensure thorough understanding of client's technical requirements to facilitate seamless configuration of platform requirements during new client implementations Test configurability of new product functionality, or enhanced existing functionality, built to accommodate custom client requirements Define test scenarios and success criteria for all new and existing client platform configurations Execute on configuration of platform requirements in accordance with project timelines and client expectations Triage and resolve technical issues, during end-to-end testing or post-implementation, in a timely manner to ensure client satisfaction Serve as a technical SME for client-facing analysts during each stage of the customer lifecycle: providing education and answers to questions around configurability of client platform requirements; occasionally interfacing directly with clients to address issues Collaborate with Product, Development, Design, and Engineering to scope, develop, and implement internal configuration management tools that will help scale configuration work What you'll need: 6+ years of professional experience in a Configuration Management role Advanced Proficiency in Excel, including advanced functions and data analysis Experience creating and updating JSON-based business rules to drive system behavior Familiarity with Jira for task tracking and project management Problem-Solving and Critical Thinking Skills: Ability to develop deep product expertise and leverage it to investigate issues and provide high-quality problem resolution Project Execution Skills: Experience setting goals and meeting deadlines for multiple ongoing projects Collaboration: Experience interfacing with internal, cross-functional stakeholders and colleagues on the development of product enhancements Bachelor's degree in Computer Science, Systems Engineering, or related field Pay & Perks: 💻 Fully remote opportunity with about 5% travel 🩺 Medical, dental, vision, life, disability insurance, and Employee Assistance Program 📈 401K retirement plan with company match; flexible spending and health savings account 🏝️ Up to 184 hours (23 days) of PTO per year + company holidays 👶 Up to 14 weeks of paid parental leave 🐶 Pet insurance The salary range for this position is $105,000 to $120,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment. Interview Process*: Connect with Talent Acquisition for a Preliminary Phone Screening Meet your Hiring Manager! Case Study Behavioral Interview Executive Interview *Subject to change About Cohere Health: Cohere Health's clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members. With the acquisition of ZignaAI, we've further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we're creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately. Cohere Health's innovations continue to receive industry wide recognition. We've been named to the 2025 Inc. 5000 list and in the Gartner Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes. The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone. We can't wait to learn more about you and meet you at Cohere Health! Equal Opportunity Statement: Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it's personal. #LI-Remote #BI-Remote

What you can expect! Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Under the direction of the Supervisor of Product System Configuration, the Analyst II - Product System Configuration is responsible for managing the more complex system configurations within the Business System. The primary functions of this position include but are not limited to, accurate interpretation of state, federal, and contractual guidelines related to benefits, fee schedules, contracts, division of financial responsibility (DOFR), codification of services, and business requirements and translating them into configurable parameters within the Business Systems. The Analyst II - Product System Configuration is independent and acts as a subject matter expert for the business areas by helping to drive decisions related to system configuration. The incumbent will develop and maintain comprehensive documentation of business and technical specification requirements utilizing best practice configuration guidelines developed by the Application Architects within the unit. The Analyst II - Product System Configuration will facilitate communication and formally report findings to various department heads and staff in a manner that is appropriate to the skill level and technical expertise of the audience. This position will be required to train and help educate other team members within the unit as necessary. Commitment to Quality: The IEHP Team is committed to incorporate IEHP's Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Additional Benefits Perks IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more. Competitive salary Telecommute schedule State of the art fitness center on-site Medical Insurance with Dental and Vision Life, short-term, and long-term disability options Career advancement opportunities and professional development Wellness programs that promote a healthy work-life balance Flexible Spending Account - Health Care/Childcare CalPERS retirement 457(b) option with a contribution match Paid life insurance for employees Pet care insurance Key Responsibilities Assist with the development of configuration standards and best practice guides for maintaining efficiency, accuracy, automation and successful integration with internal and external systems and programs. Analyze and translate business specifications into detailed technical specifications based on system functionality and develop non-systematic workaround processes when necessary. Perform product system error root cause analysis. Track incoming requests and issue resolution through Microsoft Access, MediTrac, and Workfront tools. Identify and communicate impact of system enhancements or configuration changes on integrated systems and processes. Monitor and work daily System Configuration inventory and ensure compliance with established service level agreements and regulatory timelines. Configure and maintain complex product related system builds with multi-tiered functionality and interrelated system dependencies, including but not limited to Contracts, Benefits, Fee Schedules, and Service Categories. Assist Contracting team with drafting appropriate contract fee schedule language to be in line with system adjudication capabilities and coding standards. Develop and maintain business requirements for the automation of coding updates. Track, test, and approve new system functionality, enhancements, and bug fixes, including the development and execution of test plans and scripts. Perform weekly/bi-weekly audit of check run products to proactively identify potential system configuration issues before products are released. Other duties as assigned, including but not limited to Department Projects and LEAN/A3 Events. Qualifications Education & Requirements Four (4) years of experience with the development and remediation of moderately complex system configurations, including capitated provider agreement configurations Experience in major managed care system migration/implementation preferred Bachelor's degree from an accredited institution required In lieu of the required degree, a minimum of four (4) years of additional relevant work experience is required for this position: two (2) years of general healthcare experience plus two (2) years of configuration experience is required This experience is in addition to the minimum years listed in the Experience Requirements above Key Qualifications Knowledge of Medicare and Medi-Cal fee schedules and benefit structure, and regulatory billing guidelines required Knowledge of CMS, DHCS, DMHC, NCQA rules and regulations preferred Extensive knowledge of CPT, HCPCS, Revenue, ICD10 coding rules and guidelines preferred Extensive knowledge of general managed care operations required; delegated plan model preferred Basic knowledge of relational database structure Advanced knowledge of Product System algorithms and processes preferred Familiar with basic medical product processing preferred Skilled in the use of Microsoft Excel and Access preferred Exceptional problem solving and critical thinking skills Strong presentation and written communication skills Ability to work independently and solve complex problems with little to no assistance Ability to effectively manage multiple competing priorities Position is eligible for telecommuting/remote work location upon completing the necessary steps and receiving HR approval All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership Start your journey towards a thriving future with IEHP and apply TODAY! Work Model Location This position is on a hybrid work schedule. (Monday & Friday - Remote, Tuesday - Thursday onsite in Rancho Cucamonga, CA) Pay Range USD $80,059.20 - USD $106,059.20 /Yr.

Themesoft IT Consulting team is unparalleled in experience. We have developed and maintained an extensive network of international search partners to source the best talent locally and globally. We are constantly evaluating performance on every project to ensure we're providing the highest-level of quality to match our standards in all of our fields. Job Description Benefits configuration - To configure products, benefits and plans Healthcare, Facets, SQL, NetworX Benefit Configuration, Good Communication skills Qualifications Trizetto Facets, Configuration experience is MUST Additional Information All your information will be kept confidential according to EEO guidelines.

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Come join our Peak Health team at WVU Medicine as a Benefit Configuration Analyst contributing to the foundation for an innovative, new health plan. This position will report to the Benefits Configuration Leadership, playing a unique and important role in our mission to change healthcare for the better. This role will review, implement and test new plan designs as well as update existing benefit plans via business requirements while working with IT for technical solutions. The Benefits Team will analyze and update CPT, HCPC and ICD-10 coding along with ensuring compliance with CMS and other insurance governance agencies using expert data analysis. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Associate degree in health information, healthcare, or related field AND One (1) year of experience in health insurance, medical coding, claims processing or related field. OR 2. High School Diploma or equivalent AND Three (3) years of experience in health insurance, medical coding, claims processing or related field. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor's degree in health information, healthcare, or related field. EXPERIENCE: 1. 6 years' experience in health insurance and benefit design. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Test and maintain health insurance benefit plans in the company's systems, ensuring accuracy and compliance with regulatory requirements. 2. Conduct regular audits and reviews of benefit configurations to identify discrepancies, inconsistencies, or errors. 3. Resolve configuration errors in a timely manner and document changes. 4. Work closely with IT teams to ensure seamless integration of benefit configurations into the company's technology platforms. 5. Maintain comprehensive documentation for benefit configuration, ensuring that processes and procedures are well-documented. 6. Evaluate and validate all medical billing codes, various coding services and align to accurate benefit coding. 7. Perform audits on all clinical documents and prepare coding to provide support to all services. 8. Perform research on various coding methods and facilitate all plans to resolve all discrepancies and coordinate with all clinical and non-clinical groups to manage documents according to required guidelines. 9. Administer review of professional billing systems and perform research to resolve all coding errors and evaluate all claims work queues. 10. Review procedure code master file and evaluate authenticity of all entries and evaluate all through efficient usage of codes. 11. Analyze and maintain all code master files for all inappropriate codes and inform staff for same and collaborate with staff to resolve all coding issues and ensure accuracy of same. 12. Perform testing of coding and policy changes via reports, claim adjudication and other testing software. 13. Manage and resolve all discrepancies in entry of codes and maintain knowledge on all procedural codes and reimbursement plans and prepare reports for all coding guidelines. 14. Maintain knowledge and compliance of CMS (Center for Medicare Services) guidelines and coding/billing processes. Ensure compliance with other insurance governance agencies. 15. Participate in and support all training in regard to new benefit designs or benefit changes as the result of CMS or other insurance regulations. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Prolonged periods of sitting and standing. 2. Visual strain may be encountered in viewing computer screens and written material. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Standard office environment. 2. Some travel may be required to offsite meetings. SKILLS AND ABILITIES: 1. Strategic and Independent thinking. 2. Demonstrated knowledge of federal and state insurance guidelines with CMS and others. 3. Excellent written and oral communication. 4. Demonstrated ability to build and retain relationships. 5. Proficiency with Microsoft Office. 6. Attention to detail, the ability to be organized and to be able to perform multiple tasks simultaneously. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Exempt) Company: PHH Peak Health Holdings Cost Center: 500 PHH Administration

Welcome! We're excited you're considering an opportunity with us! To apply to this position and be considered, click the Apply button located above this message and complete the application in full. Below, you'll find other important information about this position. Come join our Peak Health team at WVU Medicine as a Benefit Configuration Analyst contributing to the foundation for an innovative, new health plan. This position will report to the Benefits Configuration Leadership, playing a unique and important role in our mission to change healthcare for the better. This role will review, implement and test new plan designs as well as update existing benefit plans via business requirements while working with IT for technical solutions. The Benefits Team will analyze and update CPT, HCPC and ICD-10 coding along with ensuring compliance with CMS and other insurance governance agencies using expert data analysis. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Associate degree in health information, healthcare, or related field AND One (1) year of experience in health insurance, medical coding, claims processing or related field. OR 2. High School Diploma or equivalent AND Three (3) years of experience in health insurance, medical coding, claims processing or related field. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: 1. Bachelor's degree in health information, healthcare, or related field. EXPERIENCE: 1. 6 years' experience in health insurance and benefit design. CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position. They are not intended to be constructed as an all-inclusive list of all responsibilities and duties. Other duties may be assigned. 1. Test and maintain health insurance benefit plans in the company's systems, ensuring accuracy and compliance with regulatory requirements. 2. Conduct regular audits and reviews of benefit configurations to identify discrepancies, inconsistencies, or errors. 3. Resolve configuration errors in a timely manner and document changes. 4. Work closely with IT teams to ensure seamless integration of benefit configurations into the company's technology platforms. 5. Maintain comprehensive documentation for benefit configuration, ensuring that processes and procedures are well-documented. 6. Evaluate and validate all medical billing codes, various coding services and align to accurate benefit coding. 7. Perform audits on all clinical documents and prepare coding to provide support to all services. 8. Perform research on various coding methods and facilitate all plans to resolve all discrepancies and coordinate with all clinical and non-clinical groups to manage documents according to required guidelines. 9. Administer review of professional billing systems and perform research to resolve all coding errors and evaluate all claims work queues. 10. Review procedure code master file and evaluate authenticity of all entries and evaluate all through efficient usage of codes. 11. Analyze and maintain all code master files for all inappropriate codes and inform staff for same and collaborate with staff to resolve all coding issues and ensure accuracy of same. 12. Perform testing of coding and policy changes via reports, claim adjudication and other testing software. 13. Manage and resolve all discrepancies in entry of codes and maintain knowledge on all procedural codes and reimbursement plans and prepare reports for all coding guidelines. 14. Maintain knowledge and compliance of CMS (Center for Medicare Services) guidelines and coding/billing processes. Ensure compliance with other insurance governance agencies. 15. Participate in and support all training in regard to new benefit designs or benefit changes as the result of CMS or other insurance regulations. PHYSICAL REQUIREMENTS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Prolonged periods of sitting and standing. 2. Visual strain may be encountered in viewing computer screens and written material. WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 1. Standard office environment. 2. Some travel may be required to offsite meetings. SKILLS AND ABILITIES: 1. Strategic and Independent thinking. 2. Demonstrated knowledge of federal and state insurance guidelines with CMS and others. 3. Excellent written and oral communication. 4. Demonstrated ability to build and retain relationships. 5. Proficiency with Microsoft Office. 6. Attention to detail, the ability to be organized and to be able to perform multiple tasks simultaneously. Additional Job Description: Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Exempt) Company: PHH Peak Health Holdings Cost Center: 500 PHH Administration

What you'll do In a few words… Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning… As a Pharmacy Network & Pricing Configuration Analyst, you will be responsible for pharmacy network and pricing configuration within our Pharmacy Benefit Management (PBM) environment. This role is focused on configuring, validating, and supporting pharmacy network participation and pricing logic for Medicare, Medicaid, Commercial, and Employer clients, ensuring accurate claims adjudication and compliance with regulatory and client requirements. The fundamentals for the job… Serve as the primary support for pharmacy network and pricing configuration, including network setup, contracted rates, and pricing rules for new client implementations and existing plan changes. Configure and maintain pricing logic to ensure accurate claims adjudication aligned with client documentation and contractual agreements. Support configuration changes related to pharmacy network participation and pricing structures across multiple lines of business. Perform unit testing focused on network and pricing configuration, validating adjudication outcomes against expected pricing and network rules. Research and resolve claims adjudication issues related to network participation or pricing discrepancies, including root cause analysis, impact assessment, and corrective actions. Provide first-tier triage support for network and pricing-related claims processing issues within defined SLAs/SLOs. Collaborate with configuration peers, adjudication, product, and operational teams to execute accurate network and pricing configuration solutions. Take ownership of project-based configuration work, ensuring timelines and deliverables are met. Identify network and pricing functionality required to meet client outcomes and support implementation execution. Develop and maintain an in-depth understanding of Darwin (proprietary adjudication platform) logic related to pharmacy network and pricing configuration. Stay current with Medicare, Medicaid, and state regulatory requirements, ensuring network and pricing configurations remain compliant. Provide consultation and peer review for network and pricing configuration practices. Support the Sr. Analyst in documenting client plan standards, configuration processes, and operational procedures. Evaluate network and pricing configuration workflows and recommend process improvements. What we expect of you The bold requirements… Associate or bachelor's degree. (In lieu of a degree, equivalent relevant work experience may be considered.) 3+ years of hands-on experience in PBM Pharmacy Network & Pricing configuration, including pharmacy network setup and pricing rule implementation. 2+ years of experience within PBM operations, such as configuration, adjudication support, pharmacy networks, or Medicare-related functions. Experience using SQL and Excel to validate network participation and pricing outcomes in claims adjudication. Strong analytical skills with the ability to identify pricing and network-related issues and determine root cause. Excellent oral and written communication skills. Ability to collaborate effectively across technical and operational teams. We are proud to offer a flexible hybrid work model which will require certain on-site workdays (Puerto Rico Location Only). This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members. This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable). Nice to haves… Experience with pharmacy network contracting, pricing models, or MAC list management. Experience in a healthcare non-retail pharmacy or PBM setting. Prior experience working directly with Darwin or similar adjudication platforms. Physical requirements… Must be able to access and navigate each department at the organization's facilities. Sedentary work that primarily involves sitting/standing. At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca's workforce reflects the communities it serves. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. “Abarca Health LLC does not sponsor employment visas at this time” The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It's simply meant to give readers an idea of what the role entails. #LI-REMOTE #LI-TA1

Remote SAP Variant Configurator Analyst needs 3-5 years of experience in SAP VC or AVC modeling with complex products and/or systems. Remote SAP Variant Configurator Analyst requires: 3-5 years of experience in SAP VC or AVC modeling with complex products and/or systems. Experience in SAP SD or PP with discrete manufacturing is preferable SQL and VBA programming is preferable. EDI/ALE integration experience or knowledge is preferable. Strong programming CST 8A-5P Bachelor Degree or higher in Engineering, Computer Science, or related field of study 3-5 years of experience in SAP VC or AVC modeling with complex products and/or systems. Electronic Data Exchange (EDI) / Application Link Enabling (ALE) integration experience or knowledge Expert SAP experience, preferably in Variant Configurator modeling, bills of material maintenance, engineering changes, or super-user capabilities in unrelated module(s) Experience using SQL and VBA to mine data from relational databases Able to work some weekends or evenings Able to speak to technical and non-technical audiences, as well as absorb and use technical documentation Keen eye towards processes, and how to improve them Technical Writing ability to document work procedures to be shared across the organization Ability to multi-task and work under pressure to hit tight deadlines Product Lifecycle Management / Windchill experience Implementation in the discrete manufacturing industry Remote SAP Variant Configurator Analyst duties: Design and implement variant configuration models with the SAP VC module for New Products and maintain existing products lines Design and implement models using characteristics, classes, configurable materials, configuration profiles, procedures, selection conditions, variant pricing, super routing, Super Bom, user interface, variant tables, Material variants and sales order costing etc. Variant configuration in Sales and Distribution (SD) and Production Planning (PP) modules Gather, aggregate and store information from a variety of sources for a variety of purposes. Systems include, but are not limited to, SQL Server databases, SAP variant configuration and engineering change modules SQL data maintenance and VBA code modification Electronic Data Exchange (EDI) / Application Link Enabling (ALE) with SAP and non-SAP systems Manage all bills of materials, both variable and static, for commercial and residential HVAC with SAP LO-VC

You will be the Configuration Analyst for the JASSM & LRASM Production & Development Team. Our team drives the delivery of next generation precision strike weapons, handling design changes, configuration control, and document release for both unclassified and classified contracts. What You Will Be Doing As the Data Management Engineer you will be responsible for safeguarding program data, executing the document release process, and coordinating change control activities across engineering, quality, manufacturing, and subcontractors. You'll act as the data integrity hub that keeps the JASSM and LRASM programs on schedule and compliant. Your responsibilities will include: * Manage data for unclassified and classified contracts, ensuring strict security and configuration management compliance. * Execute the Document Release process for all program documentation, securing proper authorization and distribution. * Analyze proposed product design changes, assess system impact, and develop change order packages. * Coordinate modification records and change orders with internal teams and subcontractors for management control. * Prepare clear reports on change effects-performance, cost, schedule-and present them to stakeholders. * Review released engineering change data and synchronize updates with engineering, quality, support, manufacturing, and data control groups. * Verify that customer requirements are fully implemented throughout the change control lifecycle. * Monitor change accounting activities to ensure adherence to configuration management policies. Why Join Us You are a collaborative, detail oriented professional who thrives in a fast paced, mission critical environment. In this role you'll work side by side with world class engineers, gain exposure to classified programs, and influence the evolution of cutting edge strike weapons. We value continuous improvement, offer robust growth opportunities, and provide a culture where your expertise directly shapes national security capabilities. If you're ready to make a tangible impact while advancing a premier aerospace organization, apply today. We are committed to supporting your work-life balance and overall well-being, offering flexible scheduling options Learn more about Lockheed Martin's comprehensive benefits package here. Further Information About This Opportunity: This position is in Orlando, FL. MUST BE A U.S. CITIZEN - The selected candidate must have a Final Secret clearance. Basic Qualifications: Prior experience with data management and document release processes. * Possess good computer skills, including knowledge of MS Office software (Word, Excel, PowerPoint). * Possess strong written and oral communication skills. * Has an active Secret clearance. Desired Skills: Expertise in document release in Windchill PLM and CDRL/SDRL processing in DMAT. * Familiarity with markings (including export control markings), formatting and handling of documentation. * Experience with SharePoint management and control. Security Clearance Statement: This position requires a government security clearance, you must be a US Citizen for consideration. Clearance Level: Secret Other Important Information You Should Know Expression of Interest: By applying to this job, you are expressing interest in this position and could be considered for other career opportunities where similar skills and requirements have been identified as a match. Should this match be identified you may be contacted for this and future openings. Ability to Work Remotely: Part-time Remote Telework: The employee selected for this position will work part of their work schedule remotely and part of their work schedule at a designated Lockheed Martin facility. The specific weekly schedule will be discussed during the hiring process. Work Schedules: Lockheed Martin supports a variety of alternate work schedules that provide additional flexibility to our employees. Schedules range from standard 40 hours over a five day work week while others may be condensed. These condensed schedules provide employees with additional time away from the office and are in addition to our Paid Time off benefits. Schedule for this Position: 4x10 hour day, 3 days off per week Lockheed Martin is an equal opportunity employer. Qualified candidates will be considered without regard to legally protected characteristics. The application window will close in 90 days; applicants are encouraged to apply within 5 - 30 days of the requisition posting date in order to receive optimal consideration. Join us at Lockheed Martin, where your mission is ours. Our customers tackle the hardest missions. Those that demand extraordinary amounts of courage, resilience and precision. They're dangerous. Critical. Sometimes they even provide an opportunity to change the world and save lives. Those are the missions we care about. As a leading technology innovation company, Lockheed Martin's vast team works with partners around the world to bring proven performance to our customers' toughest challenges. Lockheed Martin has employees based in many states throughout the U.S., and Internationally, with business locations in many nations and territories. Experience Level: Experienced Professional Business Unit: MISSILES AND FIRE CONTROL Relocation Available: Possible Career Area: Product Support Type: Full-Time Shift: First

Curative is reimagining health insurance - with $0 out of pocket costs and by reducing barriers to people seeking care. Help us create a better healthcare experience for our members by making it easy & intuitive for them to access the care they need. We believe in a clear, simple health plan that allows our members to get zero-cost in-network care anytime they need it. We want to put healthcare back in the hands of the patient and clinicians, with a focus on preventative care. SUMMARY Curative wants to change the view on what a health plan can be. Born out of the pandemic, we created a health plan reinvented for a post-pandemic world that is built around a whole person's affordable preventive care featuring more benefits. Curative is looking for a HealthRules Payer Configuration Analyst who is passionate about helping the company as we work to reinvent healthcare options. Candidates will be able to utilize their previous experience in the medical field by increasing satisfaction and retention by providing Curative health plan members, patients, and providers with accurate, consistent, timely information. They will provide support while building rapport and collaborative relationships with current and prospective members in accordance with compliance guidelines. This is a remote position. ESSENTIAL DUTIES AND RESPONSIBILITIES ● Configure complex professional and facility contracts within the HealthRules Payer system ● Configure and maintain HRP configuration for claims, pricing, and benefits ● Investigate and resolve configuration issues on the HealthRules Payer system to ensure timely and accurate claims payment and account implementation ● Maintain clear and accurate documentation of all configuration activities and decisions ● Prepare and execute test cases to validate that configuration changes function as expected ● Review and resolve claim pends on a daily basis to ensure claims are processed timely ● A team player; perform tasks in a very fast paced environment. ● Work on claims team projects and reporting, as assigned. ● Attend departmental training when required or requested. ● Adhere to the rules and regulations of Curative as described in the Employee Handbook and as defined in the unit/department/clinic procedures. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions: ● 3+ years of health plan configuration experience within the HealthRules Payer platform; experience with provider contract configuration using HRL (Health Rules Language). ● 5+ years of experience in claims processing of all claim types, including hospital/facility, behavioral health, dental, vision, and professional medical claims. ● Operational experience in a health plan environment in or more of the following domains: enrollment/eligibility, provider data management, or account installation. ● Knowledge of medical terminology, ICD-10, CPT, HCPCS, and revenue codes. ● Preferred qualification: Familiarity with claim coding and editing rules. ● Preferred qualification: experience with SQL, including understanding and creating queries ● Proficient computer skills to include Microsoft Office applications and Google Suite ● Excellent verbal and written communication skills ● Ability to sit for extended periods of time at a computer workstation. ● Ability to Multitask and think creatively. ● Performs other duties and projects assigned. EDUCATION and/or EXPERIENCE ❑ Associate's degree (A. A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.

Koniag Technology and Infrastructure Solutions, LLC, a Koniag Government Services company, is seeking a Business Analyst/Tester to support KTIS and our government customer. This position requires the candidate to be able to obtain a Public Trust. This is a remote position. We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending accounts, paid holidays, three weeks paid time off, and more. Koniag Technology and Infrastructure Solutions is seeking an experienced Business Analyst/Tester with specialized knowledge of ServiceNow to join our team. The ideal candidate will have a strong background in business process analysis, requirements gathering, and solution design, with specific expertise in ServiceNow implementations and optimizations. This role is critical in bridging the gap between business needs and technical solutions, ensuring that our ServiceNow implementations deliver maximum value to stakeholders. **Essential Functions, Responsibilities & Duties may include, but are not limited to:** The Business Analyst/Tester will be responsible for analyzing business processes, documenting requirements, and helping design ServiceNow solutions that meet organizational needs. Principal responsibilities will include but are not limited to: + Conduct business process analysis to identify opportunities for improvement and automation through ServiceNow + Gather, document, and validate business requirements from stakeholders at all levels of the organization + Translate business requirements into functional specifications for ServiceNow implementations + Create detailed documentation including use cases, process flows, user stories, and acceptance criteria + Collaborate with technical teams to ensure requirements are properly implemented in ServiceNow solutions + Serve as a liaison between business stakeholders and technical teams throughout the project lifecycle + Facilitate workshops and meetings to elicit requirements and build consensus among stakeholders + Develop and maintain process maps, workflow diagrams, and other visual representations of business processes + Validate solution designs against business requirements and user needs + Coordinate user acceptance testing and gather feedback for solution refinement + Support change management activities related to ServiceNow implementations + Analyze current state processes and recommend improvements leveraging ServiceNow capabilities + Develop metrics and KPIs to measure the success of ServiceNow implementations + Stay current with ServiceNow capabilities and releases to inform solution recommendations + Provide subject matter expertise on ServiceNow modules and functionalities + Support the development of training materials and documentation for end users **Education and Experience:** + Bachelor's degree in Business Administration, Information Systems, Computer Science, or related field + 5+ years of experience as a Business Analyst or similar role + 3+ years of experience with ServiceNow platform and implementations + Proven track record of successful IT project delivery, particularly with ServiceNow **Required Skills and Competencies:** + Strong understanding of business analysis methodologies and best practices + Experience with requirements gathering techniques and documentation standards + Knowledge of ServiceNow platform capabilities, modules, and configurations + Proficiency in process mapping and workflow design + Experience creating detailed functional specifications and user stories + Strong facilitation and stakeholder management skills + Excellent verbal and written communication abilities + Experience with user acceptance testing and quality assurance processes + Understanding of ITIL practices and IT service management principles + Ability to understand complex business processes and translate them into technical requirements + Strong analytical and problem-solving skills + Experience with Agile and/or traditional project methodologies + Proficiency with requirements management and documentation tools + Ability to build consensus among diverse stakeholder groups + Experience with change management principles and practices **Desired Skills and Competencies:** + Experience with multiple ServiceNow modules (ITSM, CSM, ITBM, etc.) + Background in government contracting environments + Knowledge of data analysis and reporting tools + Experience with ServiceNow platform governance + Background in organizational change management + Experience with business process reengineering + Knowledge of user experience design principles + Experience with enterprise architecture concepts + Background in IT governance frameworks + Experience with ServiceNow development capabilities + Knowledge of integration concepts and approaches + Project management experience or certification + Experience with requirements traceability + Background in customer experience design **Security Requirement:** + Ability to obtain a Public Trust **Our Equal Employment Opportunity Policy** The company is an equal opportunity employer. The company shall not discriminate against any employee or applicant because of race, color, religion, creed, ethnicity, sex, sexual orientation, gender or gender identity (except where gender is a bona fide occupational qualification), national origin or ancestry, age, disability, citizenship, military/veteran status, marital status, genetic information or any other characteristic protected by applicable federal, state, or local law. We are committed to equal employment opportunity in all decisions related to employment, promotion, wages, benefits, and all other privileges, terms, and conditions of employment. The company is dedicated to seeking all qualified applicants. If you require an accommodation to navigate or apply for a position on our website, please get in touch with Heaven Wood via e-mail at accommodations@koniag-gs.com or by calling ************ to request accommodations. _Koniag Government Services (KGS) is an Alaska Native Owned corporation supporting the values and traditions of our native communities through an agile employee and corporate culture that delivers Enterprise Solutions, Professional Services and Operational Management to Federal Government Agencies. As a wholly owned subsidiary of Koniag, we apply our proven commercial solutions to a deep knowledge of Defense and Civilian missions to provide forward leaning technical, professional, and operational solutions. KGS enables successful mission outcomes for our customers through solution-oriented business partnerships and a commitment to exceptional service delivery. We ensure long-term success with a continuous improvement approach while balancing the collective interests of our customers, employees, and native communities. For more information, please visit_ _****************** _._ **_Equal Opportunity Employer/Veterans/Disabled. Shareholder Preference in accordance with Public Law 88-352_** **Job Details** **Job Family** **Software and Systems Development** **Job Function** **Business Systems Analyst** **Pay Type** **Salary**

HMA is the premier third-party health plan administrator across the PNW and beyond. We relentlessly deliver on our promise to provide medium to large-size employers with customized health plans. We offer various high-quality, affordable healthcare plan options supported with best-in-class customer service. We are proud to say that for four years, HMA has been chosen as a ‘Washington's Best Workplaces' by our Staff and PSBJ™. Our vision, ‘Proving What's Possible in Healthcare™,' and our values, People First!, Be Extraordinary, Work Courageously, Own It, and Win Together, shape our culture, influence our decisions, and drive our results. What we are looking for: We are always searching for unique people to diversify our team. We only hire people that care deeply about others, thrive in evolving environments, gain satisfaction from being part of a team, are motivated by tackling complex challenges, are courageous enough to share ideas, action-oriented, resilient, and results-driven. What you can expect: You can expect an inclusive, flexible, and fun culture, comprehensive salary, pay transparency, benefits, and time off package with plenty of personal development and growth opportunities. If you are looking for meaningful work, a clear purpose, high standards, work/life balance, and the ability to contribute to something important, find out more about us at: ************************** How YOU will make a Difference: This role is responsible for the successful implementation and programming clients benefit plans, as setting up buy up products for our clients as well as managing third party vendor files. The importance of this role is to ensure benefits are correctly programmed and product services are readily available for members. What YOU will do: Review prior SPD's and make recommendations for new group implementations, such as system capabilities and regulatory requirements, and present to new clients as needed. Ask clarifying questions about plan details that could be missing. Create and update plan summaries and program the claims system for simple and medium complexity client renewals and implementation of off-cycle benefit changes. With the assistance of the Plan Building Specialist II or III, assist with programming updates for clients with complex renewals. Assist with complex and escalated customer service issues to ensure resolution. maintaining the vendor file maintenance for buy-up products. This includes incoming/outgoing files, setting up SFRP and retroactive programming of the balance of our Book of Business, to facilitate non-standard benefits for select groups. Work with vendor to ensure accurate EOB design and setup as needed. Review and respond to applicable TechOps Support tickets and MDI claims queries as needed. Assist Plan Building Specialist III with programming new group implementations as needed. Assist with complex and escalated customer service issues to ensure resolution. Retroactive programming of the balance of our Book of Business, to facilitate non-standard benefits for select groups. Assist in training of Plan Building Specialist I team members. Review and respond to applicable TechOps Support tickets and MDI claims queries as needed. Conduct peer-to-peer audit for Plan Building team programming. Requirements Knowledge, Experience, and Key Attributes needed for Success: High school diploma or equivalent experience required 3-5 years of recent relevant experience Strong QicLink knowledge is beneficial for the programming of benefits in QicLink. Strong analytical skills are crucial for translating client intent into programming of their benefits in QicLink. Comprehensive understanding of benefits that we administer and different plan types. Solid understanding of regulations that impact benefit design, including but not limited to, the Affordable Care Act, Mental Health Parity and IRS rules related to administration of high deductible health plans. Clear and effective verbal and written communication skills. Strong interpersonal skills and ability to work with team members at all levels. Benefits The base salary for this position in the greater Seattle area is $108,000-$120,000 and varies dependent on geography, skills, experience, education, and other job or market-related factors. Performance-based incentive bonus(es) is available. Disclaimer: The salary, other compensation, and benefits information are accurate as of this posting date. HMA reserves the right to modify this information at any time, subject to applicable law. In addition, HMA provides a generous total rewards package for full-time employees that includes: Seventeen (IC) days paid time off (individual contributors) Eleven paid holidays Two paid personal and one paid volunteer day Company-subsidized medical, dental, vision, and prescription insurance Company-paid disability, life, and AD&D insurances Voluntary insurances HSA and FSA pre-tax programs 401(k)-retirement plan with company match Annual $500 wellness incentive and a $600 wellness reimbursement Remote work and continuing education reimbursements Discount program Parental leave Up to $1,000 annual charitable giving match How we Support your Work, Life, and Wellness Goals At HMA, we believe in recognizing and celebrating the achievements of our dedicated staff. We offer flexibility to work schedules that support people in all time zones across the US, ensuring a healthy work-life balance. Employees have the option to work remotely or enjoy the amenities of our renovated office located just outside Seattle with free parking, gym, and a multitude of refreshments. Our performance management program is designed to elevate career growth opportunities, fostering a collaborative work culture where every team member can thrive. We also prioritize having fun together by hosting in person events throughout the year including an annual all hands, summer picnic, trivia night, and a holiday party. We hire people from across the US (excluding the state of Hawaii and the cities of Los Angeles and San Francisco.) HMA requires a background screen prior to employment. Protected Health Information (PHI) Access Healthcare Management Administrators (HMA); employees may encounter protected health information (PHI) in the regular course of their work. All PHI shall be used and disclosed on a need-to-know-basis and according to HMA's standard policies and procedures. HMA is an Equal Opportunity Employer. For more information about HMA, visit ******************

The Configuration Systems Analyst II Leads and defines system requirements associated with Member Benefits, Provider Reimbursement and payment systems requirements definition, documentation, design, testing, training and implementation support using appropriate templates or analysis tools. Essential Functions: Identify, manage and document the status of open issues. Develop and utilize reports to analyze and stratify data in order to address gaps and provide answers to issues identified within the department or by other departments, utilizing TriZetto or Optum for research and correction. Utilize available tools provided by relevant State or Federal websites to obtain pertinent Fed/State Regulatory Transmittals and Fee Schedules. Plan/implement new software releases including testing and training. Participate in meetings with business owners and users to achieve a Plan benefit design and Provider Reimbursement. Serve as liaison between IT and business areas to research requirements for IT projects, meet with decision makers to translate IT specifications and define business requirements and system goals. Lead review of benefits or provider reimbursement as well as identify and design appropriate changes. Lead in the development and execution of test plans and scenarios for all benefit or reimbursement designs and for the core business system and related processes. Provides detail analysis of efficiencies related to system enhancement/automation. Review, analyze, and document the effectiveness and efficiency of existing systems and develop strategies for improving or further leveraging these systems. Conduct preliminary studies to define needs and determine feasibility of system design. Audit configuration to ensure accuracy and tight internal controls to minimize fraud and abuse and overpayment related issues. Ensure system processes and documents exist as basis for system logic. Assists in resolution for potential business risk, including communication and escalation as necessary. Vendor management between TriZetto and CareSource. Applies use of tools to define requirements such as data modeling, use case analysis, workflow analysis and functional analysis. Perform any other job related instructions as requested Education and Experience: High School Diploma or GED is required Bachelor's Degree or equivalent years of relevant work experience is preferred Minimum of three (3) years health plan experience, to include two (2) years of configuration or clinical editing software experience is required Exposure to Facets is preferred Competencies, Knowledge and Skills: Advanced computer skills with Microsoft Word, Excel, Access, Visio and abilities in Facets Proven understanding of database relationships required Understanding of DRG and APC reimbursement methods Understanding of CPT, HCPCs and ICD-CM Codes Knowledge of HIPAA Transaction Codes Critical listening and thinking skills Decision making/problem solving skills Enhanced communication skills both written and verbal Can work independently and within a team environment Attention to detail Understanding of the healthcare field Knowledge of Medicaid/Medicare Claims processing skills Proper grammar usage Time management skills Proper phone etiquette Customer service oriented Facets knowledge/training Proper claim coding knowledge Ability to be telecommuter Broad understanding of business considerations and functionality preferred Licensure and Certification: Certified Medical Coder (CPC) is preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $64,980.00 - $103,950.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-GB1

Sr. Salesforce Solutions Analyst College Board - Technology Role Type: This is a full-time position About the Team We are a team of technologists working together to solve complex technical problems and develop innovative solutions. Embracing a culture of continuous improvement, we look for ways to incorporate new technologies in the delivery of systems that are responsible for analysis and scoring of tests of SAT/PSAT and AP programs. We regularly collaborate while pitching and sharing our ideas to help define the future of our applications. Our team is characterized by our positive team culture, strong technical skills, focus on delivering value and our ability to have fun while being productive. About the Opportunity We are seeking a Senior Salesforce Solution Analyst with advanced expertise in Salesforce platform, scalable solution design, and enterprise systems and process analysis. This role requires deep Salesforce platform knowledge, hands-on configuration skills, and the ability to collaborate closely with business stakeholders and engineering teams to deliver high-quality, technically sound Salesforce solutions. The ideal candidate brings significant experience working across Sales Cloud, Service Cloud, and Experience Cloud, with strong capabilities in data modeling, declarative automation, integration concepts, and platform governance. You will play a critical role in aligning business processes and needs with Salesforce technical capabilities, ensuring solution design adheres to architectural standards, security frameworks, and engineering best practices. Reporting to the Staff Engineering Director, this role works in an Agile environment and contributes to the evolution of Salesforce as a strategic enterprise platform-driving technical enhancements, process automation, and solution scalability across the organization. In this role, you will: Technical Solution Design & Architecture Alignment Translate business requirements into technical specifications, solution designs, and scalable Salesforce configurations. Partner with engineering teams to ensure solutions align with platform architecture, data models, security models, and integration patterns. Configure and optimize Salesforce features using Flows, validation rules, Lightning App Builder, and other declarative tools in accordance with best practices. Support enhancements across Sales Cloud, Service Cloud, and Experience Cloud, ensuring solutions are scalable, maintainable, and compliant with governance standards. Solution Analysis & Solution Design Lead requirements discovery with stakeholders and convert business needs into well-defined user stories and acceptance criteria for technical implementation. Produce future-state process designs, system workflows, configuration documentation, and platform functional specifications. Collaborate with developers, admins, architects, QA, and product owners to validate requirements and ensure technical solutions meet functional and non-functional expectations. Support UAT planning and execution, defect triage, release readiness, and production validation. Platform Optimization & Continuous Improvement Identify and implement opportunities to reduce technical debt and manual processes through automation and improved platform design. Evaluate Salesforce releases and emerging capabilities to proactively recommend platform improvements and modernization opportunities. Contribute to platform governance, change management, and Salesforce DevOps pipelines (e.g., Gearset, Copado, Salesforce DX) by ensuring clear requirements and documentation for technical teams. About You Bachelor's degree in Information Systems, Business Administration, or a related field preferred Minimum 6-7 years of professional experience as a Solutions Analyst, with at least 4-5 years working specifically with Salesforce in a technology or consulting-focused environments. Strong knowledge of Salesforce declarative tools, including Flows, Process Builder, validation rules, and reports/dashboards Familiarity with Sales Cloud, Service Cloud, and Experience Cloud functionality and use cases Experience creating detailed documentation, process maps, and requirements specifications Excellent stakeholder management and communication skills, with the ability to bridge business and technical teams Experience working in Agile environments, writing user stories, and supporting sprint planning and backlog refinement Strong organizational skills and ability to manage multiple priorities in a fast-paced environment Nice to have: Familiarity with integration concepts (REST/SOAP APIs, middleware) to support collaboration with technical teams Exposure to Salesforce DevOps tools (e.g., Gearset, Copado, Salesforce DX) from a business requirements perspective Salesforce Solutions Analyst or Administrator certification Exceptional candidates can effectively speak to: Experience and Expertise Expertise working with Salesforce CRM, of performing business analysis, requirements gathering, and system support for enterprise applications including Salesforce. Demonstrated ability to partner with business units to understand needs, translate them into user stories, and deliver enhancements that drive adoption and measurable value. Stakeholder Engagement & Collaboration Experience facilitating workshops, prioritization sessions, and requirements reviews with diverse business units and technical teams. Ability to balance competing priorities across multiple stakeholders and guide discussions toward outcomes aligned with enterprise strategy. Solution Quality & Governance Experience validating data, supporting compliance reviews, and ensuring solutions adhere to governance, security, and architectural standards. Strong understanding of Agile delivery, testing processes, and iterative solution development. Content-Specific and Technical Skills Familiarity with Salesforce capabilities (e.g., Sales Cloud, Service Cloud, integrations, reporting). Proficiency in business process documentation, data analysis, and writing clear user stories with acceptance criteria. Experience supporting testing (UAT), validating data, and ensuring solutions meet compliance and governance standards. Comfort working in an agile environment, including backlog refinement, sprint planning, and iterative delivery. All roles at College Board require: A passion for expanding educational and career opportunities and mission-driven work Curiosity and enthusiasm for emerging technologies, with a willingness to experiment with and adopt new AI-driven solutions and comfort with learning and applying new digital tools independently and proactively. Clear and concise communication skills, written and verbal A learner's mindset and a commitment to growth: welcoming diverse perspectives, giving and receiving timely, respectful feedback, and continuously improving through iterative learning and user input. A drive for impact and excellence: solving complex problems, making data-informed decisions, prioritizing what matters most, and continuously improving through learning, user input, and external benchmarking. A collaborative and empathetic approach: working across differences, fostering trust, and contributing to a culture of shared success About Our Process Application review will begin immediately and will continue until the position is filled. This role is expected to accept applications for a minimum of 5 business days. While the hiring process may vary, it generally includes: resume and application submission, recruiter phone/video screen, hiring manager interview, performance exercise such as live coding, a panel interview, a conversation with leadership and reference checks. What We Offer At College Board, we offer more than a paycheck- we provide a meaningful career, a supportive team, and a comprehensive package designed to help you thrive. We're a self-sustaining nonprofit that believes in fair and competitive compensation grounded in your qualifications, experience, impact, and the market. A Thoughtful Approach to Compensation The hiring range for this role is $150,000-$163,000. Your exact salary will depend on your location, experience, and how your background compares to others in similar roles at the College Board. We aim to make our best offer upfront, rooted in fairness, transparency, and market data. We adjust salaries by location to ensure fairness, no matter where you live. You'll have open, transparent conversations about compensation, benefits, and what it's like to work at College Board throughout your hiring process. Check out our careers page for more. #LI-DC1 #LI-REMOTE

Cornerstone Building Brands, headquartered in Cary, North Carolina, is the largest manufacturer of external building products in North America with over $6 billion in annual revenue and an expansive national footprint that includes almost 20,000 employees, operating in +70 manufacturing facilities, supported by a network of +80 distribution and branch office facilities. We have a broad product offering with a well-regarded brand portfolio including the #1 position in windows; vinyl siding; metal accessories; metal roofing and wall systems; and insulated metal panels. Job Description The Lead Business Analyst for Business Intelligence will collaborate with the ERP transformation project team, spanning various Aperture business areas and corporate functions. The goal is to develop, support, and implement BI solutions using Power BI and Azure reporting capabilities. This role involves working closely with business stakeholders, IT, and third parties to create solid business requirements documents and project deliverables. Responsibilities: Reporting and Data Gap Analysis: Collaborate with ERP project leaders and business SMEs to identify reporting and data gaps for specific business units. Requirements Gathering: Work closely within ERP project and stakeholders to understand their data-related requirements, including data visualization needs, reporting requirements, and data modeling preferences. Data Analysis: Analyze data from various sources to identify trends, patterns, and insights that can inform business decisions. Use statistical analysis techniques to extract actionable insights. Data Quality Assurance: Ensure the accuracy, completeness, and reliability of data used for visualization and modeling purposes. Address data quality issues through cleansing, validation, and verification processes. Documentation and Communication: Document data models, visualization designs, and analytical findings to ensure transparency and knowledge sharing. Communicate complex technical concepts to non-technical stakeholders clearly and concisely. Ad Hoc Reporting: Prepare ad hoc reports as needed by various stakeholders. Testing and QA: Develop and execute test plans, guide testers during the QA process, determine required testing resources, and manage the issue tracking process. Knowledge and Skills: Excellent oral and written communication skills, with the ability to market and report complex initiatives to non-technical colleagues or business leadership. Expertise with Microsoft Power BI, or other BI platform including troubleshooting and automation to streamline operations. Familiarity with ERP systems like SAP, Orace JDE , Oracle EBS Blend of ERP and business process acumen (e.g., O2C, P2P), consulting abilities, and analytics capabilities to identify needs and develop optimal solutions. Strong problem-solving skills and business intuition. Proficiency with Azure reporting tools and SQL. Qualifications Bachelor's degree, or similar technical discipline 3+ years in leading business intelligence and analytics initiatives 5+ years of experience working with data analytics and prior Power BI proven experience, including prior roles as data analyst, data reporter or business analyst. Experience in project management and overseeing processes from conception to completion also helpful. Must be able to travel up to 20% Additional Information All your information will be kept confidential according to EEO guidelines.