Remote Health Plan Configuration Analyst II

Healthcare Management Administrators Inc; Bellevue (WA); Hybrid; USD 90,000 - 110,000; Full time

Benefits offered by this job

Seventeen (IC) days paid time off

Eleven paid holidays

Two paid personal day

One paid volunteer day

Company-subsidized medical, dental, 4-

vision, and prescription insurance

Company-paid disability, life, and AD&

Voluntary insurances

HSA and FSA pre-tax programs

401(k) retirement with company match

Annual wellness incentive and wellness

Remote work reimbursements

Discount program

Parental leave

Up to $1,000 charitable giving match

Job summary

Healthcare Management Administrators (HMA) is seeking a skilled Plan Configuration Analyst to implement and optimize client benefit plans. You will set up buy-up products, configure benefits in the claims system, and manage third-party vendor files to ensure accurate programming for members.

Located near Seattle, this role supports remote work with a comprehensive rewards package, competitive base salary, and opportunities for professional growth.

Qualifications

• 3-5+ years of recent Health Plan Configuration experience.
• Comprehensive understanding of administered benefits and plan types.
• Understanding of self-funded plan structures, accumulators, stop-loss, and employer-specific variations.
• Strong ability to analyze benefit documents (SPDs, plan summaries) and translate into system rules.
• Knowledge of regulations impacting benefit design (ACA, Mental Health Parity, IRS rules for high-deductible plans).
• Experience troubleshooting configuration issues and validating system outputs.
• Familiarity with claims platforms or HRP systems used by TPAs.
• Clear and effective verbal and written communication skills.
• Strong interpersonal skills and ability to work with team members at all levels.
• Ability to create and run SQL queries.
• Ability to analyze and understand medical claims adjudication logic.

Responsibilities

• Configure and validate benefits for new and renewing clients.
• Collaborate with partners to gather and clarify requirements.
• Review existing benefit plans and advise on new group implementations and design.
• Configure benefits into the claims system and prepare end-user docs.
• Document workflows and configuration decisions; update processes.
• Troubleshoot configuration issues and propose solutions.
• Review change requests for completeness and alignment with processes.
• Provide training and assist in developing training materials.
• Communicate status and risks to senior analysts and Plan Configuration Manager.
• Support ticket reviews and respond to claims queries as needed.
• Manage SSO tools for non-preferred PBMs.
• Conduct peer audits of claims system configuration.
• Coordinate with Level III analyst on BlueCard requirements; negotiate with CHP; process payments and setup plan prefixes.
• Assist Finance with EOB setup auditing.
• Participate in annual compliance reviews for preventative services.
• Contribute to department and company-wide projects.

Skills

SQL queries

Benefits configuration

Regulatory compliance

Healthcare claims knowledge

Analytical skills

Education

High school diploma or equivalent

Tools

Claims system

HRP systems

BlueCard setup

Job description

Healthcare Management Administrators (HMA) is seeking a skilled Plan Configuration Analyst to implement and optimize client benefit plans. You will set up buy-up products, configure benefits in the claims system, and manage third-party vendor files to ensure accurate programming for members.

Located near Seattle, this role supports remote work with a comprehensive rewards package, competitive base salary, and opportunities for professional growth.