Remote Health Plan Configuration Analyst II (PA/PD)

SHPCA SCAN Health Plan; Long Beach (CA); Remote; USD 72,000 - 104,000; Full time

Benefits offered by this job

Annual bonus program

Wellness program

PTO

Holidays

401(k) with match

Tuition reimbursement

Job summary

SCAN Health Plan is seeking a Configuration Analyst II to manage PA and PD code sets across claims and related systems. You will work with Medical Policy, Utilization Management, IT, and vendors to ensure accurate configuration, testing, and deployment.

The role requires hands-on data analysis, SQL, and QNXT experience, with a focus on accuracy, timelines, and continuous improvement in benefit configuration and reporting.

Qualifications

• Bachelor's degree or equivalent in healthcare/related field.
• 2+ years in healthcare systems, operations, analytics, or technical functions.
• 2+ years in reporting, data analysis, SQL, or healthcare data.
• Experience with coding systems and authorization processes.
• CPT/HCPCS coding knowledge.
• Understanding CMS/MediCal/Medicare requirements preferred.
• Strong analytical and problem-solving skills with data interpretation.
• Proficiency with Office Suite and BI tools.

Responsibilities

• Maintain PA and PD code sets across claims and systems.
• Support benefit configuration and PA activities from config to deployment.
• Serve as technical liaison for PA/PD configuration with teams and vendors.
• Troubleshoot configuration issues impacting workflows.
• Support AEP readiness with configuration tasks and timelines.
• Analyze data to identify trends, risks, and impacts.
• Improve workflows, reporting, data quality, and system functionality.
• Create and maintain procedures and training materials.
• Keep knowledge of healthcare coding standards and CMS regs.

Skills

SQL

Power BI

Data analysis

QNXT

CPT/HCPCS knowledge

CMS regulations familiarity

Education

Bachelor's degree in Healthcare Administration or related field

Tools

Power BI

MHK

ikaSystems

CareAxis

Job description

SCAN Health Plan is seeking a Configuration Analyst II to manage PA and PD code sets across claims and related systems. You will work with Medical Policy, Utilization Management, IT, and vendors to ensure accurate configuration, testing, and deployment.

The role requires hands-on data analysis, SQL, and QNXT experience, with a focus on accuracy, timelines, and continuous improvement in benefit configuration and reporting.