Configuration Analyst II

Healthcare Management Administrators•Bellevue, WA

4d•Remote

About The Position

The Configuration Analyst II is responsible for implementing and programming client benefit plans, setting up buy-up products, and managing third-party vendor files to ensure benefits are configured correctly and services are available to members. The role performs system configuration and validation for new and renewing clients, translates benefit requirements into claims-system rules, documents configuration and workflows, and troubleshoots configuration issues. It also supports audits, training, compliance reviews, vendor-related work, and department and company projects.

Requirements

High school diploma or equivalent experience.
3–5+ years of recent relevant health plan configuration experience.
Comprehensive understanding of administered benefits and different plan types.
Understanding of self-funded plan structures, accumulators, stop-loss, and employer-specific plan variations.
Ability to analyze benefit documents such as SPDs and plan summaries and translate them into system rules.
Strong understanding of regulations affecting benefit design, including the Affordable Care Act, Mental Health Parity, and IRS rules for administering high-deductible health plans.
Experience troubleshooting configuration issues and validating system outputs.
Clear and effective verbal and written communication skills.
Strong interpersonal skills and ability to work with team members at all levels.
Ability to analyze and understand medical claims adjudication logic.

Nice To Haves

Growing familiarity with claims platforms or HRP systems used by third-party administrators.
Ability to create and run SQL queries.

Responsibilities

Perform system configuration and validation for new and renewing clients.
Collaborate with business partners to gather and clarify requirements.
Review prior benefit plans and make recommendations for new group implementations, including system capabilities, regulatory requirements, and benefit design; present recommendations to new clients.
Configure benefits in the claims system and prepare corresponding end-user documentation for new group implementations.
Revise claims-system benefit configurations and prepare documentation for renewing clients and off-cycle benefit changes.
Document workflows, configuration decisions, and process updates.
Troubleshoot configuration issues and recommend solutions.
Review change requests for completeness and alignment with existing processes.
Provide Plan Configuration Analyst training and education, and assist with developing training materials.
Communicate status updates and risks to senior analysts and the Plan Configuration Manager.
Review and respond to applicable TechOps Support tickets and BPO claims queries as needed.
Manage the SSO tool for non-preferred PBMs.
Conduct peer-to-peer audits of claims-system configuration.
Set up BlueCard requirements with a Level III analyst, including CHP negotiations, CBF payment processing, PAR requests, and plan-prefix setup.
Work with Finance on EOB setup auditing as needed.
Participate in code categorization decisions and lead reviews of annual compliance requirements related to preventive services.
Participate in department and company-wide projects as needed.

Benefits

Seventeen paid time-off days for individual contributors.
Eleven paid holidays.
Two paid personal days and one paid volunteer day.
Company-subsidized medical, dental, vision, and prescription insurance.
Company-paid disability, life, and AD&D insurance.
Voluntary insurance options.
HSA and FSA pre-tax programs.
401(k) retirement plan with company match.
Annual $500 wellness incentive and $600 wellness reimbursement.
Remote work reimbursement.
Continuing education reimbursement.
Discount program.
Parental leave.
Up to $1,000 annual charitable giving match.
Performance-based incentive bonus(es).
Flexible work schedules.
Remote work option or access to the renovated office, with free parking, a gym, and refreshments.