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 reputed company 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 reputed company causes and remediation reputed company, and reputed company 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 reputed company 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. reputed company 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 reputed company 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.
• reputed company 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 reputed company, 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 reputed company-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.
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