Associate Systems Analyst (Health Plan)

Location: Information Technology Center, Morgantown, West Virginia, United States. Standard office environment; travel to other WVUHS facilities or affiliated sites may be required for implementations, training, and support.

Company

hirify.global is part of the West Virginia University Health System, providing healthcare services and supporting clinical and health plan operations.

What you will do

• Support configuration, implementation, maintenance, testing, and optimization of software systems.
• Configure and test Utilization Management, Pharmacy, prior authorization, medical necessity, appeals, and grievance workflows.
• Translate clinical, operational, and regulatory requirements into system requirements, workflow designs, and testing scenarios.
• Serve as a liaison between IT, Utilization Management, Pharmacy, Medical Management, and other health plan teams.
• Assist with troubleshooting, user security management, data transfers, reporting, issue resolution, and system improvements.
• Coordinate project plans, schedules, documentation, risks, meetings, and status reporting, while providing end-user training and support.

Requirements

• Bachelor’s degree in Computer Science, Information Technology, or a related field, or two years of relevant experience.
• Foundational ability to analyze business needs, document functional specifications, create workflow diagrams, troubleshoot systems, and support testing.
• Strong written and verbal communication, collaboration, prioritization, adaptability, and attention to detail.
• Knowledge of healthcare interoperability standards such as HL7, FHIR, and DICOM is preferred.
• Working knowledge of health plan concepts, including benefits, claims, authorizations, medical necessity, and pharmacy benefits, is preferred.
• Clinical experience or licensure, such as RN, LPN, PharmD/RPh, or Pharmacy Technician, is strongly preferred.

Nice to have

• Experience with Utilization Management, Pharmacy, prior authorization, Medical Management, managed care, payer, PBM, or health plan operations.
• Experience with Epic Tapestry or comparable payer technology.
• Knowledge of cloud-based healthcare applications, web services, reporting tools, and clinical data management.

Culture & Benefits

• Full-time schedule of 40 hours per week on the day shift.
• Opportunity to develop technical knowledge through training sessions, workshops, professional resources, and knowledge sharing.
• Work includes collaboration with clinical, operational, and IT teams in a supportive environment.
• Reasonable accommodations may be provided for qualified individuals with disabilities.