Job Information
Premera Blue Cross Sr. Product Configuration Analyst in Mountlake Terrace, Washington
Join Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives! As a result of these efforts we are proud to share that Forbes ranked Premera among America’s 2023 Best Midsize Employers (https://www.forbes.com/lists/best-midsize-employers/?sh=58210f5e210f) and America's 2023 Best Employers By State (https://www.forbes.com/lists/best-employers-by-state/?sh=21c7c3d1983b) .
Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com .
The Sr Product Configuration Analyst is responsible for building and configuring group product selections within the appropriate systems. They provide solutions for standard and non-standard benefit configuration as well as implementation for standard and non-standard product selections by Small, Mid-Market and Large employer groups and the Individual Market. They are required to develop a thorough understanding of the benefit selection from Sales and then apply that to the configuration of the system’s product components such as the administrative rules, EOB rules, claims processing rules, provider network identification, utilization management rules and detailed benefit administration rules. Accurate and timely configuration of benefits is the key component in ensuring that customers can access their benefits including customer service, pharmacy and claims processing.
What you will do:
Utilize source documents to analyze and then configure standard and non-standard products and benefit provisions for Small, Mid-Market and Large employer groups and the Individual Market.
Analyze and interpret the product selection and product changes, determine the gap between standard and custom benefits, consider system constraints and propose alternate solutions. Identify clarifications needed and inconsistent or incomplete product documents and gather information needed to ensure appropriate configuration of those elements.
Configure the product “shell”, product components, benefit summary details, accumulators, and existing language for the benefit quoting tool to ensure the timely generation of ID cards, payment of medical, dental, and pharmacy claims, and tools for quoting benefits on multiple platforms (customer service, on-line portals, etc.).
Work with sales and operations to identify appropriate application of system restraints and considerations and request clarifications on product intent when needed.
Analyze system generated reports to identify appropriate configuration updates.
Provide timely and consistent status updates to all stakeholders and workgroups to ensure a smooth and efficient process for new and renewing groups. Participate in group implementation meetings to identify changes and provide knowledge for current product configuration.
Provide support and analysis to retro-product updates and to ensure timely completion and movement into production.
Research and respond to inquiries from other departments regarding benefit administration.
Participate in project work and other duties on behalf of Product Configuration.
What you will bring:
Associate’s degree in a related field such as Information Systems, Business Administration, or two (2) years’ professional work experience (Required).
Three (3) years work experience in claims, customer service, membership and billing, quality audit, product configuration or similar area (Required).
Experience or training using Premera systems or equivalent (Required).
Good working knowledge of health insurance products, provisions, and terminology.
Advanced experience in Excel or Access.
Prior health care experience.
What we offer
Medical, vision and dental coverage
Life and disability insurance
Retirement programs (401K employer match and pension plan)
Wellness incentives, onsite services, a discount program and more
Tuition assistance for undergraduate and graduate degrees
Generous Paid Time Off to reenergize
Free parking
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at careers@premera.com or via phone at 425-918-4785.
Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin .
The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.
National Salary Range:
$51,600.00 - $82,600.00
National Plus Salary Range:
$58,800.00 - $94,100.00
*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska .
At Premera, we make healthcare work better. By focusing on improving our customers’ experience purposefully and serving their needs passionately, we make the process easier, less costly, and more positive. Through empathy and advocacy, we change lives.
As the leading health plan in the Pacific Northwest, we provide comprehensive health benefits and services to more than 2 million customers, from individuals to Fortune 100 companies. Our services include innovative programs focused on health management, wellness, prevention, and patient safety. We deliver these programs through health, life, vision, dental, disability, and other related products and services.
Premera Blue Cross is headquartered in Mountlake Terrace, WA, with operations in Spokane and Anchorage. The company has operated in Washington since 1933 and in Alaska since 1952. With more than 80 years of experience in the region, we deliver innovation, choice, and expertise.