Senior Healthcare Configuration & Testing Analyst

name; United States; On-site; USD 120,000 - 160,000; Full time

Benefits offered by this job

ESPP (Employee Stock Purchase Plan)

Reimbursement for office setup

Monthly cell phone & internet stipend

Remote-first culture

Job summary

Clover Health is seeking a highly analytical Senior Strategic Configuration Analyst to validate and test configuration logic for member benefits, provider contracts, and edits. You will design testing frameworks, run complex scenario models, and collaborate with cross-functional teams to ensure precise, CMS-compliant configurations before production deployments.

You will leverage AI tools to generate test scenarios and analyze failures, driving improvements in validation cycles while maintaining

Qualifications

• 5+ years of experience in Medicare Advantage or healthcare plan configuration, testing, or QA
• Hands-on experience with HealthEdge HRP and Source
• Detail-oriented with ability to identify rare, high-dollar edge cases
• Strong understanding of end-to-end claim lifecycle and provider contracts in a claims system

Responsibilities

• Design and execute test plans to validate member benefits, provider contracts, and edits in our systems.
• Develop complex scenario-based testing models simulating real-world encounters.
• Provide defect impact analysis and risk assessments for configuration divergences.
• Manage validation lifecycle across testing and UAT environments for zero-defect deployments.
• Use AI tools to generate test scenarios and summarize configuration requirements.
• Collaborate with Configuration, Payment Integrity, and stakeholders to move logic to production.
• Document test results and configuration procedures for CMS compliance.

Skills

Medicare Advantage

Testing & QA

HealthEdge HRP

Edge case identification

AI-assisted testing

Tools

HealthEdge HRP

HealthEdge Source

Job description

Clover Health is seeking a highly analytical Senior Strategic Configuration Analyst to validate and test configuration logic for member benefits, provider contracts, and edits. You will design testing frameworks, run complex scenario models, and collaborate with cross-functional teams to ensure precise, CMS-compliant configurations before production deployments.

You will leverage AI tools to generate test scenarios and analyze failures, driving improvements in validation cycles while maintaining