The Facets Sr. Provider Configuration Analyst will configure pricing into a Facets platform which uses NetworX pricing capabilities for Practitioners, Acute Care Hospitals, Critical Access Hospitals, Ambulatory Surgical Centers, Federally Qualified Heath Care (FQHCs), Rural Health Clinics, Dialysis, and Ancillary provider types. The person in this role will be accountable for reading, interpreting, and translating provider fee for service and capitation contracts (or other pricing documents) into configuration design templates to facilitate contract loading (by self or others). They will also participate in month-end and reconciliation processes required to support capitated provider contracts.
Primary Responsibilities:
Reading and interpreting provider contracts, or other pricing artifacts, to complete provider configuration design templates
Creating standard NetworX templates within Facets and on paper as a guide for Config Analysts to use to configure new
Extracting and analyzing pricing data to help assess business processes such as configuration accuracy, capitation allocation payments, and to resolve provider pricing inquiries and/or pended claims
Complete quality control measures, to include claim modeling, to ensure accuracy of NetworX Agreement configuration.
Identify process improvement opportunities to improve accuracy and timeliness (i.e., automation, turn-around time, etc.)
Manage assigned inventory to ensure timely contract load
Perform user acceptance testing on new/changed pricing tools
Serve as subject matter expert regarding configuration and/or Facets capabilities
Provide direction in selecting the appropriate Configuration Template(s) and/or request new designs for new pricing requirements
Required Qualifications:
High school diploma or GED
3 years of Provider Pricing Configuration in Facets/NetworX
3 years of experience reading, interpreting, and translating provider contracts for professional, facility and ancillary providers
3 years of physician, facility, and ancillary contract reimbursement methodology with Medicare & commercial products
Self-directed individual with a proven track record of strong organizational skills and ability to adapt quickly to change
Strong communication skills to translate complex or technical information clearly and concisely for diverse internal audiences
Proven ability to manage productivity and efficiency to visualize and achieve set goals for delivery of contracts for installation
Intermediate level of proficiency with Microsoft Word / Excel / Outlook / SharePoint
Strong customer focus with proven ability to anticipate, understand, and meet the needs of internal and external customers
Previous provider capitation experience
Preferred Qualifications:
Experience working with Cognizant DOFR / FARM applications
Undergraduate degree in business or healthcare preferred
Dexian is a leading provider of staffing, IT, and workforce solutions with over 12,000 employees and 70 locations worldwide. As one of the largest IT staffing companies and the 2nd largest minority-owned staffing company in the U.S., Dexian was formed in 2023 through the merger of DISYS and Signature Consultants. Combining the best elements of its core companies, Dexian's platform connects talent, technology, and organizations to produce game-changing results that help everyone achieve their ambitions and goals.
Dexian's brands include Dexian DISYS, Dexian Signature Consultants, Dexian Government Solutions, Dexian Talent Development and Dexian IT Solutions. Visit https://dexian.com/ to learn more.
Dexian is an Equal Opportunity Employer that recruits and hires qualified candidates without regard to race, religion, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.