We exist for workers and their employers -- who are the backbone of our economy. That is where Centivo comes in -- our mission is to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills.
We are hiring for a Core Platform System Analyst, which emphasizes technical execution and support. This role is critical to ensuring the stability, performance, and alignment of our core platform systems with organizational goals. The ideal candidate will have a deep understanding of plan building, benefits design, and systems configuration, alongside core platform expertise. You will collaborate with cross-functional teams, including IT, Operations, Claims, and Compliance, to ensure system stability, data integrity, and efficient process workflows.
Key Responsibilities:
Core Platform Support & Optimization:
Serve as a subject matter expert (SME) for core platform systems, including claims processing, member management, provider networks, and benefits configuration.
Troubleshoot, analyze, and resolve issues related to platform functionality, system configuration, and performance.
Work 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.
Plan Building & Benefits Configuration:
Lead and support the design and configuration of health plans, benefits structures, and benefit rule sets in the core platform system.
Collaborate with business stakeholders to ensure health plan design and benefits configurations align with customer requirements and regulatory guidelines.
Configure and maintain benefits, networks, claims rules, and other key system elements related to health plan operations.
Assist with the development and maintenance of benefit plans and ensure they are properly integrated into the platform, ensuring accurate benefits administration.
Business Analysis & Requirements Gathering:
Work closely with business users (Claims, Enrollment, IT, etc.) to gather and document system requirements, and translate them into actionable, functional specifications.
Conduct gap analyses to identify system inefficiencies and collaborate with the team to implement 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, performing regular audits and validation checks to maintain high-quality data.
Develop and execute test plans to ensure system changes meet business needs and functional specifications.
Document system configurations, updates, and changes, ensuring that all processes are clearly outlined 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 ensure platform systems are optimized to meet business needs.
Regulatory Compliance & Reporting:
Ensure core platform systems comply with healthcare industry regulations, including HIPAA, CMS, ACA, and other applicable standards.
Assist in creating and delivering necessary reports and dashboards that monitor key performance indicators (KPIs) related to health plans, claims, member services, and provider operations.
Project Management:
Support the planning, coordination, and execution of system upgrades, platform changes, and new implementations.
Manage system-related projects from initiation through to completion, ensuring timely delivery within scope and budget.
Qualifications:
Education:
Bachelor's degree in Information Technology, Computer Science, Health Information Management, or a related field. Relevant certifications (e.g., Health IT, Business Analysis) are a plus.
Experience:
5+ years of experience working with core platform systems in a health plan, TPA, or healthcare-related setting.
Must have experience with HealthRules Payer
Hands-on experience with health plan building, benefits configuration, and system administration in core platform systems.
Strong knowledge of claims processing systems, member management platforms, and provider networks.
Familiarity with healthcare operations, including claims adjudication, enrollment, and provider management processes.
Skills & Competencies:
Strong analytical and problem-solving skills with the ability to translate business needs into system configurations and solutions.
Deep 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 both 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 (CBAP, PMI-PBA) or IT systems management is a plus.
Location:
Role may be remote, preference for Buffalo, NY.
Values:
Resilient – This is wicked hard. There is no easy button for healthcare affordability. Luckily, the mission makes it worth it and sustains us when things are tough. Being resilient ensures we don’t give up.
Uncommon - The status quo stinks so we had to go out and build something better. We know the healthcare system. It isn't working for members, employers, and providers. So we're building it from scratch, from the ground up. Our focus is on making things better for them while also improving clinical results - which is bold and uncommon.
Positive – We care about each other. It takes energy to do hard stuff, build something better and to be resilient and unconventional while doing it. Because of that, we make sure we give kudos freely and feedback with care. When our tank gets low, a team member is there to be a source of new energy. We celebrate together. We are supportive, generous, humble, and positive.
Who we are:
Centivo is an innovative health plan for self-funded employers on a mission to bring affordable, high-quality healthcare to the millions who struggle to pay their healthcare bills. Anchored around a primary care based ACO model, Centivo saves employers 15 to 30 percent compared to traditional insurance carriers. Employees also realize significant savings through our free primary care (including virtual), predictable copay and no-deductible benefit plan design. Centivo works with employers ranging in size from 51 employees to Fortune 500 companies. For more information, visit centivo.com.
Headquartered in Buffalo, NY with offices in New York City and Buffalo, Centivo is backed by leading healthcare and technology investors, including a recent round of investment from Morgan Health, a business unit of JPMorgan Chase & Co.
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