Job Title: Platform and Configuration Specialist

Salary: $105K - $115K Location Type: Remote Employment Type: FullTime

Position Overview

Centivo is dedicated to bringing affordable, high-quality healthcare to millions who struggle with healthcare costs. We are seeking a skilled Platform and Configuration Specialist to support our core platform systems. This role is crucial for ensuring the efficient and effective operation of our provider data and claims platforms, translating business needs into technical solutions, and maintaining data integrity.

Key Responsibilities

Platform and Configuration Support

• Serve as a subject matter expert (SME) for provider data and claims platforms.
• Troubleshoot, analyze, and resolve issues related to platform functionality, system configuration, and performance.
• Collaborate with technical teams to identify and implement system enhancements, fixes, and updates to improve platform performance and meet business requirements.
• Monitor and optimize system performance, proactively addressing issues to prevent disruptions in business operations.

Business Analysis & Requirements Gathering

• Work closely with business users (Claims, PDM, IT, etc.) to gather and document system requirements, translating them into actionable, functional specifications.
• Conduct gap analyses to identify system inefficiencies and collaborate on implementing solutions that improve workflows and business processes.
• Provide subject matter expertise on system configuration, ensuring new features and changes meet business needs.

Data Integrity & Quality Assurance

• Ensure data accuracy, integrity, and consistency across systems through regular audit and validation checks.
• Develop and execute test plans to ensure system changes meet business needs and functional specifications.
• Document system configurations, updates, and changes, ensuring clear outlining of all processes for internal use.

Collaboration & Training

• Act as a liaison between technical teams and business users to ensure system solutions align with business goals and requirements.
• Provide technical support and training for end-users on system functionality, process changes, and best practices.
• Foster collaboration across departments to optimize platform systems for business needs.

Project Management

• Support the planning, coordination, and execution of system upgrades, platform changes, and new implementations.
• Manage system-related projects from initiation through completion, ensuring timely delivery within scope and budget.

Qualifications

Education

• Bachelor's degree in a relevant field such as Healthcare, Business, Computer Science, or Mathematics.

Experience

• 5+ years of experience working with core platform systems in a health plan, TPA, or healthcare-related setting.
• Experience with Health Rules Payer is preferred.
• Experience with Provider Data profiles and network configuration.
• Hands-on experience with health plan building, benefits configuration, and system administration in core platform systems.
• Familiarity with healthcare operations, including claims adjudication, enrollment, and provider management processes.

Skills & Competencies

• Advanced skills in data analysis tools (e.g., Excel, PowerPoint, SQL).
• Strong analytical and problem-solving skills with the ability to translate business needs into system configurations and solutions.
• Understanding of plan building, benefits configuration, and related system settings.
• Experience with system integrations and interfacing with third-party vendors.
• Knowledge of healthcare regulations and standards, including HIPAA, CMS, and ACA.
• Proficient in project management and documentation tools (e.g., JIRA, Confluence, Microsoft Project).
• Excellent communication skills, both written and verbal, with the ability to engage with technical and non-technical stakeholders.
• Detail-oriented with a strong focus on system optimization, data integrity, and process improvement.
• Ability to manage multiple priorities and deadlines in a fast-paced environment.

Preferred Qualifications

• Familiarity with business intelligence tools (e.g., Tableau, Power BI) for reporting and analysis.
• Certification in Business Analysis or related fields is a plus.