Remote Configuration Lead, Healthcare Payer Contracts

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

Benefits offered by this job

Annual bonus program

Wellness Program

Generous PTO

11 holidays + 1 floating + 1 birthday

Job summary

SCAN Health Plan in Long Beach, CA seeks a Configuration Program Lead to manage contract-related configuration initiatives. You will translate contractual requirements into precise system configurations, coordinate testing, and collaborate with cross‑functional teams to ensure compliant delivery.

The role requires 5 years in healthcare payer operations and strong SQL/Visio/Microsoft Office skills. This is a mostly remote position offering a robust benefits package and opportunities to influence

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 and compliant 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

SQL

Visio

Microsoft Office

Education

Bachelor's Degree or equivalent experience

Tools

Visio

Job description

SCAN Health Plan in Long Beach, CA seeks a Configuration Program Lead to manage contract-related configuration initiatives. You will translate contractual requirements into precise system configurations, coordinate testing, and collaborate with cross‑functional teams to ensure compliant delivery.

The role requires 5 years in healthcare payer operations and strong SQL/Visio/Microsoft Office skills. This is a mostly remote position offering a robust benefits package and opportunities to influence