HybridIn-office presence is expected several days per week.
IT Operations
About the job
Requirements
Strong understanding of software development lifecycle (SDLC) methodologies.
Familiarity with AI for code generation; agent usage is preferred.
Experience with SQL queries, including extracting data and performing triage, updates, and inserts.
Ability to understand complex healthcare payment rules and design, build, and implement systems accordingly.
Effective communication with internal and external stakeholders.
Strong attention to detail and consistent work product validation and quality assurance.
Strong analytical skills.
An undergraduate degree in IT or Healthcare IT, or progressive experience.
Familiarity with Microsoft Office suite products.
Proficiency in Excel and Microsoft Access.
Proficiency in Microsoft SQL Server Management Studio.
Responsibilities
Gather and analyze requirements to build solution designs.
Handle data transformation activities.
Analyze business requirements and translate them into technical specifications.
Program new provider physician rate builds and hospital contracts, and manage ongoing rate changes.
Program new benefit configurations and manage ongoing benefit changes.
Troubleshoot, debug, and resolve application issues in a timely manner.
Interact with system vendors to enhance applications with new features and functionality.
Collaborate with IT and non-IT personnel to complete required tasks.
Participate in application upgrades, releases, and deployment activities.
Collaborate with offshore development and support teams to deliver projects, coordinate development activities, review deliverables, resolve issues, and ensure adherence to project timelines and quality standards.
Desired Qualifications
One to three years of experience in application development, programming, or systems analysis.
Prior experience in a healthcare third-party administrator or insurer environment working with claims adjudication and ancillary applications.
Familiarity with healthcare electronic data interchange transactions, including 800 and 200 series.
Familiarity with newer technologies involving AI.
About The Role We are looking for a motivated and energetic Programmer Analyst who possesses a basic understanding of the software development lifecycle, working knowledge of SQL and database concepts, and familiarity with AI technologies, including the use of agents to assist with code prototyping and development. The successful candidate will join our application support team supporting critical healthcare claims processing applications. This is a hybrid role based in our Westbury, NY office, with an in-office presence expected several days per week to support collaboration, team engagement, and business needs.
Primary Responsibilities
Be able to gather and analyze requirements to build solution designs
Effectively handle the data transformation activities
Analyze business requirements and translate them into technical specifications
Program new provider physician rate builds, hospital contracts and manages ongoing rate changes
Program new benefit configuration and manage ongoing benefit changes
Troubleshoot, debug, and resolve application issues in a timely manner.
Interact with system vendors to enhance applications with new features and functionality
Collaborate with IT and non-IT personnel to complete required tasks
Participate in application upgrades, releases, and deployment activities.
Collaborate effectively with offshore development and support teams to deliver projects, coordinate development activities, review deliverables, resolve issues, and ensure adherence to project timelines and quality standards.
Essential Qualifications
Preferred 1-3 years of experience in application development, programming, or systems analysis.
Strong understanding of software development lifecycle (SDLC) methodologies.
Familiar with use of AI for code generation; Agent’s usage preferred
Experience with SQL queries that includes but not limited ability to extract the data, triaging, update and insert functions
Preferred prior experience in Healthcare TPA or insurer environment working with the claims adjudication and ancillary applications.
Preferred familiarity with Healthcare EDI transactions including 800 and 200 series
Self-motivated and capable of independently learning new technologies, business processes, and technical skills with minimal supervision.
Ability to understand complex HealthCare payment rules and design, build and implement system accordingly
Communicate effectively with internal and external stakeholders
Strong attention to detail and perform consistent work product validation/QA
Strong analytical skills
Educational Qualifications
Undergraduate degree in IT, Healthcare IT and/or progressive experience.
Technical Qualifications
Familiar with MS Office suite products
Proficient on Excel and MS Access
Proficient in MS SQL Server Managed Studio
Familiarity with newer technologies with AI.
About
At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.
Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.
Come be a part of the Brightest Ideas in Healthcare™.
Company Mission
Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.
Company Vision
Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.
Annual Salary Range: $60,000-$75,000
The salary range and/or hourly rate listed is a good faith determination that may be offered to a successful applicant for this position at the time of the posting of an advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable by law including but not limited to location, years of relevant experience, education, credentials, skills, budget and internal equity.
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