Remote Contracts Configuration Program Lead

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

Benefits offered by this job

Mostly Remote

Annual bonus program

Wellness program

PTO (paid time off)

11 paid holidays + birthday holiday

401(k) with employer match

Tuition reimbursement

Job summary

SCAN Health Insurance is seeking a Configuration Program Lead - Contracts to manage complex configuration initiatives including DOFR, NCN, and other provider and network configuration requirements. You will translate contract terms into accurate system configuration and coordinate testing and deployment with multiple internal teams.

The role emphasizes governance, change management, and ongoing process improvements, with mostly remote work and opportunities to leverage AI-driven approaches to

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 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.

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

Problem solving

Cross-functional collaboration

Communication skills

Education

Bachelor’s Degree or equivalent experience

Tools

SQL

Microsoft Office Suite

Visio

Job description

SCAN Health Insurance is seeking a Configuration Program Lead - Contracts to manage complex configuration initiatives including DOFR, NCN, and other provider and network configuration requirements. You will translate contract terms into accurate system configuration and coordinate testing and deployment with multiple internal teams.

The role emphasizes governance, change management, and ongoing process improvements, with mostly remote work and opportunities to leverage AI-driven approaches to