Configuration Program Lead - Contracts

SCAN Group; Long Beach (CA); Remote; USD 92,000 - 134,000; Full time

Benefits offered by this job

Mostly Remote

Annual bonus program

Wellness program

Paid time off (PTO)

11+ holidays per year + floating/birth

401(k) with employer match

Employee recognition program

Tuition reimbursement

Job summary

SCAN Health Plan in Long Beach, CA seeks a Configuration Program Lead - Contracts to manage complex contract-related configuration initiatives (DOFR, NCN) and translate contractual requirements into accurate system configuration.

You will coordinate implementation, validation, testing, and issue resolution with cross-functional teams, and maintain governance and change-management processes to ensure compliance.

Qualifications

• Bachelor's Degree or equivalent experience.
• 5 years of experience in healthcare payer operations, health plan configuration, provider contract administration, network operations, claims administration, or a related field.
• Experience translating contractual and operational requirements into system configuration, coordinating testing and implementation activities, and partnering with cross-functional stakeholders to support accurate configuration processes.
• Ability to interpret and translate complex contract, provider network, and operational requirements into accurate system configuration and business rules.
• Strong knowledge of configuration implementation, testing, validation, and change management practices to ensure configuration accuracy and compliance.
• Ability to collaborate effectively with cross-functional stakeholders, including Network Management, Provider Operations, Claims, Legal, Compliance, IT, and business partners to resolve issues and achieve operational objectives.
• Strong analytical and problem-solving skills with the ability to identify configuration risks, dependencies, process improvement opportunities, and automation solutions.
• Advanced Microsoft Office Suite, SQL, and Visio skills are required.

Responsibilities

• Lead configuration activities associated with DOFR, NCN, and other contract-related requirements.
• Interpret approved contract terms and operational requirements and translate them into accurate system configuration.
• Coordinate implementation, validation, testing, and issue resolution associated with new or modified contract configuration.
• Partner with Network Management, Provider Operations, Claims, Legal, Compliance, IT, and other business partners to resolve configuration questions and discrepancies.
• Maintain governance, documentation, controls, and change-management processes for contract configuration.
• Identify configuration risks, dependencies, and opportunities for process improvement, standardization, and automation.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
• Actively support the achievement of SCAN's Vision and Goals.
• Other duties as assigned.

Skills

Analytical thinking

Cross-functional collaboration

SQL

Microsoft Office

Visio

Education

Bachelor's Degree or equivalent experience

Tools

Microsoft Office

SQL

Visio

Job description

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the "12 Angry Seniors." Their mission continues to guide everything we do.

Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.

Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.

At SCAN, we believe scale should strengthen-not dilute-our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.

The Job

The Configuration Program Lead - Contracts manages complex contract-related configuration initiatives within SCAN Health Plan, including DOFR, NCN, and other provider and network configuration requirements.

The role translates contractual and operational requirements into accurate system configuration, coordinates implementation and testing activities, and partners with business and technical stakeholders to ensure configuration changes are implemented consistently and support operational and regulatory requirements.

You Will

• Lead configuration activities associated with DOFR, NCN, and other contract-related requirements.

• Interpret approved contract terms and operational requirements and translate them into accurate system configuration.

• Coordinate implementation, validation, testing, and issue resolution associated with new or modified contract configuration.

• Partner with Network Management, Provider Operations, Claims, Legal, Compliance, IT, and other business partners to resolve configuration questions and discrepancies.

• Maintain governance, documentation, controls, and change-management processes for contract configuration.

• Identify configuration risks, dependencies, and opportunities for process improvement, standardization, and automation.

• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

• Actively support the achievement of SCAN's Vision and Goals.

• Other duties as assigned.

Your Qualifications

• Bachelor's Degree or equivalent experience.

• 5 years of experience in healthcare payer operations, health plan configuration, provider contract administration, network operations, claims administration, or a related field required.

• Experience translating contractual and operational requirements into system configuration, coordinating testing and implementation activities, and partnering with cross-functional stakeholders to support accurate and compliant configuration processes preferred.

• Ability to interpret and translate complex contract, provider network, and operational requirements into accurate system configuration and business rules.

• Strong knowledge of configuration implementation, testing, validation, and change management practices to ensure configuration accuracy and compliance.

• Ability to collaborate effectively with cross-functional stakeholders, including Network Management, Provider Operations, Claims, Legal, Compliance, IT, and business partners to resolve issues and achieve operational objectives.

• Strong analytical and problem-solving skills with the ability to identify configuration risks, dependencies, process improvement opportunities, and automation solutions.

• Advanced Microsoft Office Suite, SQL, and Visio skills are required.

What's in it for you?

• Base salary range: $92,400 to $133,671 per year

• Work Mode: Mostly Remote

• An annual employee bonus program

• Robust Wellness Program

• Generous paid-time-off (PTO)

• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday

• Excellent 401(k) Retirement Saving Plan with employer match and contribution

• Robust employee recognition program

• Tuition reimbursement

• An opportunity to become part of a team that makes a difference to our members and our community every day!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Aff?

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)