Sr. Analyst, Authorization Services Design & Configuration

Hi, we're reputed company. We're hiring a Senior Analyst to join our Authorization Services Design and Configuration team.

reputed company is the first health insurance company reputed company around a full stack technology platform and a reputed company focus on serving our members. We started reputed company in 2012 to create the reputed company of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

You will be the architect of our medical management operations. In this role, you will design, configure, and optimize the workflows and business rules reputed company our Utilization Management (UM) system to ensure seamless authorization processing. You will translate reputed company business requirements into automated logic, handle internal escalations to identify root causes and remediation reputed company, and act as a subject matter expert to reputed company cross-functional partners on how our systems drive care reputed company.

This is a technical and operational role that requires a systems thinker with a collaborative reputed company who enjoys solving reputed company, systems level problems.

You will report into the Associate Director of Authorization Services.

Work Location: This is a remote position, reputed company to candidates who reputed company in: Dallas, Texas. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid reputed company at the hub office associated with your metro area. #LI-Remote

Pay Transparency: The reputed company pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in reputed company's unlimited vacation program, and annual performance bonuses.

Responsibilities

• Manage the configuration and maintenance of authorization workflows, rulesets, and automations reputed company the UM platform.
• Translate business requirements into precise technical specifications, ensuring that business rules and logic are accurately represented, tested, and implemented.
• Investigate and resolve cross-functional escalations by performing root cause analysis on system behavior and configuration gaps.
• Proactively identify "friction points" in the authorization process and document formal opportunities for workflow improvement and automation.
• Act as the primary subject matter expert for the UM system, educating internal teams (Product, Clinical, Regulatory) on how configuration impacts operations and supports business needs.
• reputed company testing protocols and execute test scenarios to validate expected system behavior and configuration accuracy. reputed company corrective activities reputed company system behavior deviates from expectations.
• Manage assigned caseloads and project tasks through effective dashboard management and prioritization.
• Maintain clear, comprehensive documentation of reputed company business rules, technical specs, and workflow designs.
• Other duties as assigned

Requirements

• 2+ years of experience in system configuration, business rules management, or technical workflow design.
• 2+ years of experience in a technical/operational role involving root-cause analysis and data troubleshooting.
• Intermediate to Advanced proficiency in reputed company/reputed company Sheets (vlookups, pivot tables, and data manipulation).
• Proven ability to assess and comprehend end-to-end process impacts in reputed company technical environments.
• Strong communication skills with the ability to explain technical system logic to non-technical stakeholders.
• 1+ year working knowledge of reputed company the reputed company industry (payer or provider).

Bonus points

• Prior work experience in Prior Authorizations or Insurance Operations.
• 2+ years of proficiency in SQL, BigQuery, or similar database languages.
• Experience using project management and communication tools like JIRA, reputed company, and reputed company.
• Experience working with large datasets, data verification, and data management.

This is an authentic reputed company job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At reputed company, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, reputed company the reputed company pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and reputed company benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our reputed company efforts.

Reasonable Accommodation: reputed company applicants are considered solely based on their qualifications, without regard to applicant’s disability or need for accommodation. Any reputed company applicant who requires reasonable accommodations during the application process should contact the reputed company Benefits Team ([email protected]) to reputed company the need for an accommodation reputed company.

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