Contracts Configuration Lead (Remote)

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

Benefits offered by this job

Annual bonus program

Wellness program

Generous PTO

Eleven paid holidays

401(k) with employer match

Tuition reimbursement

Employee recognition program

Birthday/ floating holidays

Job summary

SCAN Health Plan is seeking a Configuration Program Lead - Contracts to manage complex contract-related configuration initiatives. You will translate contractual and operational requirements into accurate system configurations and coordinate cross-functional implementation and testing.

You will partner with Network Management, Provider Operations, Claims, Legal, Compliance, IT, and other stakeholders to resolve questions, maintain governance, and drive standardization and automation in contract

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 related field.
• Experience translating contractual/operational requirements into system configuration and coordinating testing/implementation with cross-functional stakeholders.
• Ability to interpret complex contract/provider network/operational requirements into accurate system configurations and business rules.
• Knowledge of configuration implementation, testing, validation and change management for accuracy and compliance.
• Ability to collaborate with cross-functional stakeholders to resolve issues and achieve objectives.
• Advanced Microsoft Office Suite, SQL, and Visio skills are required.

Responsibilities

• Lead configuration activities associated with DOFR, NCN, and other contract-related requirements.
• Translate approved contract terms and requirements into accurate system configuration.
• Coordinate implementation, validation, testing, and issue resolution for 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.
• Support SCAN’s vision and goals with proactive configuration excellence.
• Perform other duties as assigned.

Skills

Healthcare payer operations

Contract administration

Network operations

Claims administration

Cross-functional collaboration

Analytical/problem-solving

SQL

Microsoft Office

Visio

Education

Bachelor's Degree or equivalent experience

Tools

MS Office

SQL

Visio

Job description

SCAN Health Plan is seeking a Configuration Program Lead - Contracts to manage complex contract-related configuration initiatives. You will translate contractual and operational requirements into accurate system configurations and coordinate cross-functional implementation and testing.

You will partner with Network Management, Provider Operations, Claims, Legal, Compliance, IT, and other stakeholders to resolve questions, maintain governance, and drive standardization and automation in contract