The JobThe
Configuration Program Lead - Contracts manages complex contract-related configuration initiatives within SCAN Health Plan, including DOFR, NCN, and other provider and network configuration requirements.
The role translates contractual and operational requirements into accurate system configuration, coordinates implementation and testing activities, and partners with business and technical stakeholders to ensure configuration changes are implemented consistently and support operational and regulatory requirements.
You Will- 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.
Your 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 and compliant 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.
What's in it for you?- Base salary range: $92,400 to $133,671 per year
- Work Mode: Mostly Remote
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution
- Robust employee recognition program
- Tuition reimbursement
- An opportunity to become part of a team that makes a difference to our members and our community every day!
We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
At
SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.
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